犬咬伤伤口一期缝合和延期缝合疗效及感染率的Meta分析和系统评价

Meta analysis and systematic evaluation of the efficacy and infection rate of primary suture anddelayed suture for dog bite wound

背景一直以来临床上关于犬咬伤伤口分期缝合的方式存在一定的争议,其争议点主要为伤口的一期缝合和延期缝合。目的探讨犬咬伤伤口行一期缝合与延迟缝合在伤口愈合美观性以及感染率等方面的差异,对纳入文献的所有数据进行Meta分析和系统评价。方法依照Cochrane系统评价的方法,通过计算机输入既定的关键词,检索PubMed数据库、Cochrane library、中国知网全文数据库(CNKI)、万方全文数据库(WanFang database)、维普全文数据库(VIP database),有关犬咬伤伤口不同分期缝合方式的前瞻性研究、病例对照研究及回顾性研究的比较。按预先制定的纳入、排除标准进行筛选,并对所有纳入的试验进行亚组分析和质量评价。文献检索时间区间为自建库至2020年5月21日,运用RevMan 5.3软件对犬咬伤伤口不同分期缝合方式的伤口愈合美观性以及伤口感染率进行Meta分析和系统评价。结果与结论(1)共纳入7篇相关文献,共1240例犬咬伤患者其中采用一期缝合672例、延期缝合568例。(2)Meta分析结果显示:犬咬伤一期缝合和延期缝合在感染率方面(95%CI:0.31-1.54,P P>0.05)(3)分析结果表明:犬咬伤一期缝合和延期缝合在感染率方面差异无统计学意义。纳入文献中的2篇对伤口愈合美观率进行对比,实验组、对照组分别为(80.95%、52.38%)(54.1%、34.0%)2篇文献一致的显示一期缝合伤口愈合的美观率更高,表明在伤口愈合的美观性上一期缝合最佳。

Background There has been some controversy about the method of staged suture for dog bite wound in clinical practice,and the controversy points are primary suture and delayed suture.Objective We investigate the differences between primary suture and delayed suture in wound healing aesthetics and wound infection rate of dog bite wounds,and make a meta-analysis and systematic evaluation of all data in the included literature.Methods According to Cochrane system evaluation method,author through computer input established keywords,search PubMed database,Cochrane Library,CNKI,Wanfang database,VIP full-text database regard to a prospective study,a case-control study and a retrospective study on the different stages of suture of dog bite wounds.Screening was carried out according to the pre-determined inclusion and exclusion criteria,and subgroup analysis and quality evaluation were carried out for all the included tests.From the establishment of the database to May 21,2020,Revman 5.3 software was used to make meta analysis and systematic evaluation on the aesthetics of wound healing and wound infection rate of different stages of dog bite wounds.Results and conclusion(1)seven related literatures were included in this study.Among them,672 cases were treated with primary suture and 568 cases with delayed suture.(2)The results of meta analysis showed that the infection rate of primary suture and delayed suture in dog bite(95%CI:0.31-1.54,P>0.05)(3)there was no significant difference in infection rate between primary suture and delayed suture in dog bite.Two of the included literatures,compared the aesthetic rate of wound healing.The experimental group and the control group were respectively(80.95%,52.38%)(54.1%,34.0%),indicating that the aesthetic rate of primary suture wound healing was higher,manifesting that the aesthetic rate of primary suture wound healing was the best.