背景:初次全关节成形术(TJA)后使用引流管几乎没有益处。很少有研究调查修订TJA后的排水管使用情况。这项研究的目的是确定使用抽吸引流管是否对接受翻修术的患者有益。
方法:我们利用PubMed的系统评价和荟萃分析(PRISMA)指南的首选报告项目进行了全面的文献综述,Embase,WebofScience,科克伦图书馆本综述的纳入标准是所有以英文撰写的原始文章,调查了TKA或THA修订版中封闭式负压引流的有效性和安全性。至少报告以下结果指标之一:(1)估计失血量(EBL),(2)围手术期血红蛋白变化,(3)需要输血,(4)术后感染,(5)伤口并发症。如果文章没有英文版本或包含病例报告,则被排除在外。系统评价,注释,社论,调查,或2023年7月22日之前的动物研究。共有6项研究符合纳入标准。总的来说,655名患者进行了引流,而1765名患者在全髋关节或膝关节置换术后没有引流。荟萃分析的主要结果包括估计失血量(EBL),术后血红蛋白,需要输血。提取的其他数据包括术后感染,伤口并发症。
结果:六项研究符合纳入标准。总的来说,655名患者有引流管,而1765例患者在翻修全髋关节或膝关节置换术后没有。患者的平均年龄为66.1+/-3.4岁,平均BMI为30.3+/-0.8。术后感染无差异(p=0.14),两组之间的伤口并发症(p=0.621)或需要输血(p=0.521)。有和没有引流的患者之间的EBL(Hedges\'gCI[-3.52,2.77])或术后Hb(Hedges\'gCI[-1.65,2.41])也没有差异。
结论:我们的结果没有显示翻修全髋关节或膝关节置换术后引流管的放置有任何益处。随着成本增加,排水去除的时间和需要,这可能是不必要的干预。
方法:三级,系统评价和荟萃分析。
BACKGROUND: The use of drains after primary total joint arthroplasty (TJA) has shown little benefit. Few studies have investigated
drain usage after revision TJA. The purpose of this study was to determine whether utilizing suction drains is beneficial for patients undergoing revision arthroplasty.
METHODS: We performed a comprehensive literature review utilizing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines from the PubMed, Embase, Web of Science, and Cochrane Library. Inclusion criteria of this review were all original articles written in English investigating the efficacy and safety of closed suction drainage in revision TKA or THA, reporting at least one of the following outcome measures: (1) estimated blood loss (EBL), (2) perioperative hemoglobin change, (3) needs for transfusion, (4) postoperative infection, and (5) wound complications. Articles were excluded if they are not available in English or they included case reports, systematic reviews, comments, editorials, surveys, or animal studies prior to July 22, 2023. A total of six studies met inclusion criteria. In total, 655 patients had a
drain while 1765 patients did not have a
drain after revision total hip or knee arthroplasty. Primary outcomes included for meta-analysis included estimated blood loss (EBL), postoperative hemoglobin, need for transfusion. Other data extracted includes postoperative infections, and wound complications.
RESULTS: Six studies met the inclusion criteria. In total, 655 patients had drains, while 1765 patients did not after revision total hip or knee arthroplasty. The average age of the patients was 66.1+/- 3.4 years, and the average BMI was 30.3 +/-0.8. There was no difference in postoperative infections (p = 0.14), wound complications (p = 0.621) or need for transfusion (p = 0.521) between the two groups. There was also no difference in EBL (Hedges\' g CI[-3.52, 2.77]) or postoperative Hb (Hedges\' g CI[-1.65, 2.41]) between patients with and without drains.
CONCLUSIONS: Our results do not show any benefit from
drain placement after revision total hip or knee arthroplasty. With the increased cost, time and need for
drain removal, this is likely an unnecessary intervention.
METHODS: Level III, systematic review and meta-analysis.