中国组织工程研究 ›› 2021, Vol. 25 ›› Issue (28): 4587-4592.doi: 10.12307/2021.077

• 生物材料循证医学 evidence-based medicine of biomaterials • 上一篇    

可吸收胶原蛋白线用于Ⅰ,Ⅱ类手术切口缝合效果的Meta分析

彭一帆1,2,王  翀3,山院飞3,芦文丽4   

  1. 1天津医科大学研究生院,天津市 300070;2天津市环湖医院编辑部,天津市 300350;3天津市第一中心医院普外科,天津市   300192;4天津医科大学公共卫生学院流行病与卫生统计学教研室,天津市 300070 
  • 收稿日期:2020-07-04 修回日期:2020-07-07 接受日期:2020-07-29 出版日期:2021-10-08 发布日期:2021-05-22
  • 通讯作者: 芦文丽,博士,教授,硕士生导师,天津医科大学公共卫生学院流行病与卫生统计学教研室,天津市 300070
  • 作者简介:彭一帆,女,1982年生,天津市人,满族,2006年中国医科大学毕业,硕士,主要从事医学统计及编辑出版研究。

Efficacy of absorbable collagen suture for type I and II surgical incisions: a meta-analysis

Peng Yifan1, 2, Wang Chong3, Shan Yuanfei3, Lu Wenli4   

  1. 1Graduate School, Tianjin Medical University, Tianjin 300070, China; 2Editorial Office, Tianjin Huanhu Hospital, Tianjin 300350, China; 3Department of General Surgery, Tianjin First Central Hospital, Tianjin 300192, China; 4Department of Epidemiology and Health Statistics, School of Public Health, Tianjin Medical University, Tianjin 300070, China 
  • Received:2020-07-04 Revised:2020-07-07 Accepted:2020-07-29 Online:2021-10-08 Published:2021-05-22
  • Contact: Lu Wenli, MD, Professor, Master’s supervisor, Department of Epidemiology and Health Statistics, School of Public Health, Tianjin Medical University, Tianjin 300070, China
  • About author:Peng Yifan, Master, Graduate School, Tianjin Medical University, Tianjin 300070, China; Editorial Office, Tianjin Huanhu Hospital, Tianjin 300350, China

摘要:

文题释义:
可吸收胶原蛋白线:由高度纯化的Ⅰ型胶原蛋白制备而成的结构精密的单股缝线,其可通过人体胶原蛋白酶酶解成机体可重新利用的内源性氨基酸,具有良好的抗张强度和组织相容性。
Ⅰ,Ⅱ类手术切口:Ⅰ类切口指手术未进入炎症区,未进入呼吸、消化及泌尿生殖道,以及闭合性创伤手术符合上述条件者;Ⅱ类切口指手术进入呼吸、消化或泌尿生殖道但无明显污染。

目的:研究证实,可吸收胶原蛋白线在临床Ⅰ,Ⅱ类手术切口缝合中效果良好,但现有研究皆为单中心、小样本量的研究,研究结果尚不明确。文章系统评价可吸收胶原蛋白线用于Ⅰ,Ⅱ类手术切口的疗效。
方法:检索PubMed、Web of Science、Cochrane图书馆、中国知网、万方和维普数据库发表的关于可吸收胶原蛋白缝合线的随机对照研究,使用修改后的Jadad量表评价纳入研究文献的质量。主要结局指标为切口愈合情况、切口平整率、切口愈合时间;次要指标为切口疼痛情况、切口红肿及渗血情况。采用Stata 16.0统计软件进行Meta分析。
结果:①共纳入研究文献11篇,Jadad中位数得分为3.0分,共包括患者1 720例,其中试验组887例,对照组833例;②Meta分析结果显示:与对照组相比,试验组切口甲级愈合(RR=1.44,95%CI:1.02-1.86,P=0.00)和切口平整率均增高(RR=1.11,95%CI:0.70-1.52,P=0.002),而切口愈合时间(WMD=-7.44,95%CI:-8.09至-6.79,P=0.00)、切口疼痛程度(RR=1.95,95%CI:1.44-2.46,P=0.00)、切口渗血情况(RR=-2.63,95%CI:-4.65至-0.61,P=0.01)和切口红肿率(RR=-1.00,95%CI:-1.78至-0.22,P=0.01)均显著降低。
结论:可吸收胶原蛋白线应用于Ⅰ,Ⅱ类手术切口缝合的疗效优于丝线及普通可吸收缝合线
https://orcid.org/0000-0002-0486-7416 (彭一帆) ;https://orcid.org/0000-0003-2894-7506 (芦文丽) 

中国组织工程研究杂志出版内容重点:生物材料;骨生物材料口腔生物材料纳米材料缓释材料材料相容性;组织工程

关键词: 生物材料, 胶原蛋白, 切口, 缝合线, 愈合, 疼痛, 随机对照试验, Meta分析

Abstract:

OBJECTIVE: Absorbable collagen suture has been reported to improve the healing effect for patients with type I and II surgical incisions. However, these studies are single-center small-sample trials, and the results are not clear. This study investigated the efficacy of absorbable collagen suture for type I and II surgical incisions.

METHODS: Databases of PubMed, Web of Science, Cochrane Library, CNKI, Wanfang,and VIP were searched to retrieve the randomized controlled trials concerning the effects of absorbable collagen suture. The modified Jadad scale was used to evaluate the quality of the included research literature. The main outcome indicators were wound healing grades, wound leveling, and wound healing time. The secondary indicators were wound pain, incisional red swelling, and wound bleeding. Meta-analysis was conducted using Stata 16.0 software.

RESULTS: (1) Eleven articles were included, and the median Jadad score was 3.0. There were 1 720 patients, including 887 patients in the trial group and 833 patients in the control group. (2) Meta-analysis results revealed that compared with the control group, in the trial group, incision healing level was improved (RR=1.44, 95%CI:1.02-1.86, P=0.00), and incision flatness was improved (RR=1.11, 95%CI:0.70-1.52, P=0.002); incision healing time was significantly reduced (WMD=-7.44, 95%CI:-8.09 to -6.79, P=0.00); incision pain was significantly reduced (RR=1.95, 95%CI:1.44-2.46, P=0.00); incision bleeding was significantly reduced (RR=-2.63, 95%CI:-4.65 to -0.61, P=0.01); incisional swelling was significantly reduced (RR=-1.00, 95%CI:-1.78 to-0.22, P=0.01).
CONCLUSION: The efficacy of absorbable collagen thread for type I and II surgical incisions was better than that of the silk thread and ordinary absorbable suture. 

Key words: biomaterials, collagen, incision, suture, healing, pain, randomized controlled trial, meta-analysis

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