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Tissue Adhesives for Closure of Surgical Incisions (Review)

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Tissue Adhesives for Closure of Surgical Incisions (Review) Tissue adhesives for closure of surgical incisions (Review) Dumville JC, Coulthard P, Worthington HV, Riley P, Patel N, Darcey J, Esposito M, van der Elst M, van Waes OJF This is a reprint of a Cochrane review, prepared and maintained by The Cochrane Collaboration and published in The Cochrane Library 2014, Issue 11 http://www.thecochranelibrary.com Tissue adhesives for closure of surgical incisions (Review) Copyright © 2014 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. TABLE OF CONTENTS HEADER....................................... 1 ABSTRACT ...................................... 1 PLAINLANGUAGESUMMARY . 2 SUMMARY OF FINDINGS FOR THE MAIN COMPARISON . ..... 3 BACKGROUND .................................... 5 OBJECTIVES ..................................... 5 METHODS ...................................... 5 RESULTS....................................... 8 Figure1. ..................................... 13 Figure2. ..................................... 14 ADDITIONALSUMMARYOFFINDINGS . 20 DISCUSSION ..................................... 31 AUTHORS’CONCLUSIONS . 32 ACKNOWLEDGEMENTS . 32 REFERENCES ..................................... 33 CHARACTERISTICSOFSTUDIES . 36 DATAANDANALYSES. 95 Analysis 1.1. Comparison 1 Adhesive versus suture, Outcome 1 Dehiscence: all studies. 97 Analysis 1.2. Comparison 1 Adhesive versus suture, Outcome 2 Dehiscence: sensitivity analysis. 99 Analysis 1.3. Comparison 1 Adhesive versus suture, Outcome 3 Infection: all studies. 100 Analysis 1.4. Comparison 1 Adhesive versus suture, Outcome 4 Infection: sensitivity analysis. 101 Analysis 1.5. Comparison 1 Adhesive versus suture, Outcome 5 Cosmetic appearance rated by patient. 102 Analysis 1.6. Comparison 1 Adhesive versus suture, Outcome 6 Cosmetic appearance rated by surgeon. 102 Analysis 1.7. Comparison 1 Adhesive versus suture, Outcome 7 Patient/parent satisfaction (% satisfied). 103 Analysis 1.8. Comparison 1 Adhesive versus suture, Outcome 8 Patient/parent satisfaction (VAS Scale 0 to 100). 103 Analysis 1.9. Comparison 1 Adhesive versus suture, Outcome 9 Surgeon satisfaction (% satisfied). 104 Analysis 1.10. Comparison 1 Adhesive versus suture, Outcome 10 Time taken for wound closure. 105 Analysis 2.1. Comparison 2 Adhesive versus adhesive tape, Outcome 1 Dehiscence. 106 Analysis 2.2. Comparison 2 Adhesive versus adhesive tape, Outcome 2 Infection. 106 Analysis 2.3. Comparison 2 Adhesive versus adhesive tape, Outcome 3 Cosmetic appearance rated by patient (VAS). 107 Analysis 2.4. Comparison 2 Adhesive versus adhesive tape, Outcome 4 Cosmetic appearance rated by patient (% satisfied). ................................... 108 Analysis 2.5. Comparison 2 Adhesive versus adhesive tape, Outcome 5 Cosmetic appearance rated by surgeon (VAS). 108 Analysis 2.6. Comparison 2 Adhesive versus adhesive tape, Outcome 6 Patient satisfaction. 109 Analysis 2.7. Comparison 2 Adhesive versus adhesive tape, Outcome 7 Surgeon satisfaction. 109 Analysis 2.8. Comparison 2 Adhesive versus adhesive tape, Outcome 8 Time taken for wound closure. 110 Analysis 3.1. Comparison 3 Adhesive versus staples, Outcome 1Dehiscence. 110 Analysis 3.2. Comparison 3 Adhesive versus staples, Outcome 2Infection. 111 Analysis 3.3. Comparison 3 Adhesive versus staples, Outcome 3 Cosmetic appearance rated by patient (scar scale). 111 Analysis 3.4. Comparison 3 Adhesive versus staples, Outcome 4 Cosmetic appearance by plastic surgeons (VAS). 112 Analysis 3.5. Comparison 3 Adhesive versus staples, Outcome 5 Patient satisfaction. 113 Analysis 3.6. Comparison 3 Adhesive versus staples, Outcome 6 Time taken for wound closure. 113 Analysis 4.1. Comparison 4 Adhesive versus other method, Outcome 1 Dehiscence. 114 Analysis 4.2. Comparison 4 Adhesive versus other method, Outcome 2 Infection. 114 Analysis 4.3. Comparison 4 Adhesive versus other method, Outcome 3 Patient satisfaction. 115 Analysis 4.4. Comparison 4 Adhesive versus other method, Outcome 4 Clinician satisfaction. 116 Analysis 4.5. Comparison 4 Adhesive versus other method, Outcome 5 Time taken for wound closure. 116 Analysis 5.1. Comparison 5 Adhesive versus adhesive: High viscosity versus low viscosity, Outcome 1 Dehiscence. 117 Analysis 5.2. Comparison 5 Adhesive versus adhesive: High viscosity versus low viscosity, Outcome 2 Infection. 117 Analysis 5.3. Comparison 5 Adhesive versus adhesive: High viscosity versus low viscosity, Outcome 3 Patient satisfaction. 118 Tissue adhesives for closure of surgical incisions (Review) i Copyright © 2014 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. Analysis 5.4. Comparison 5 Adhesive versus adhesive: High viscosity versus low viscosity, Outcome 4 Clinician satisfaction. .................................. 118 Analysis 5.5. Comparison 5 Adhesive versus adhesive: High viscosity versus low viscosity, Outcome 5 Time taken for wound closure..................................... 119 Analysis 6.1. Comparison 6 Adhesive versus adhesive: octylcyanoacrylate versus butylcyanoacrylate, Outcome 1 Dehiscence. .................................. 119 Analysis 6.2. Comparison 6 Adhesive versus adhesive: octylcyanoacrylate versus butylcyanoacrylate, Outcome 2 Infection. ................................... 120 Analysis 6.3. Comparison 6 Adhesive versus adhesive: octylcyanoacrylate versus butylcyanoacrylate, Outcome 3 Cosmetic assessmentratedbypatient(VAS).. 121 Analysis 6.4. Comparison 6 Adhesive versus adhesive: octylcyanoacrylate versus butylcyanoacrylate, Outcome 4 Cosmetic assessmentratedbysurgeon(VAS). 121 Analysis 6.5. Comparison 6 Adhesive versus adhesive: octylcyanoacrylate versus butylcyanoacrylate, Outcome 5 Surgeon satisfaction(withdevice).. 122 Analysis 6.6. Comparison 6 Adhesive versus adhesive: octylcyanoacrylate versus butylcyanoacrylate, Outcome 6 Surgeon satisfaction(withclosure). 122 Analysis 6.7. Comparison 6 Adhesive versus adhesive: octylcyanoacrylate versus butylcyanoacrylate, Outcome 7 Time taken forwoundclosure. 123 ADDITIONALTABLES. 123 APPENDICES ..................................... 126 WHAT’SNEW..................................... 132 HISTORY....................................... 133 CONTRIBUTIONSOFAUTHORS . 133 DECLARATIONSOFINTEREST . 134 SOURCESOFSUPPORT . 135 DIFFERENCES BETWEEN PROTOCOL AND REVIEW . .... 135 INDEXTERMS .................................... 135 Tissue adhesives for closure of surgical incisions (Review) ii Copyright © 2014 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. [Intervention Review] Tissue adhesives for closure of surgical incisions Jo C Dumville1, Paul Coulthard2, Helen V Worthington3, Philip Riley3, Neil Patel4, James Darcey2, Marco Esposito3, Maarten van der Elst5, Oscar J F van Waes5 1School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK. 2Department of Oral and Maxillofacial Surgery, School of Dentistry, The University of Manchester, Manchester, UK. 3Cochrane Oral Health Group, School of Dentistry, The University of Manchester, Manchester, UK. 4Oral Surgery, University Dental Hospital of Manchester, Manchester, UK. 5Department of Surgery, Reinier de Graaf Groep, Delft, Netherlands Contact address: Jo C Dumville, School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, M13 9PL, UK. [email protected]. Editorial group: Cochrane Wounds Group. Publication status and date: New search for studies and content updated (no change to conclusions), published in Issue 11, 2014. Review content assessed as up-to-date: 12 March 2014. Citation: Dumville JC, Coulthard P, Worthington HV, Riley P, Patel N, Darcey J, Esposito M, van der Elst M, van Waes OJF. Tissue adhesives for closure of surgical incisions. Cochrane Database of Systematic Reviews 2014, Issue 11. Art. No.: CD004287. DOI: 10.1002/14651858.CD004287.pub4. Copyright © 2014 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. ABSTRACT Background Sutures (stitches), staples and adhesive tapes have been used for many years as methods of wound closure, but tissue adhesives have entered clinical practice more recently. Closure of wounds with sutures enables the closure to be meticulous, but the sutures may show tissue reactivity and can require removal. Tissue adhesives offer the advantages of an absence of risk of needlestick injury and no requirement to remove sutures later. Initially, tissue adhesives were used primarily in emergency room settings, but this review looks at the use of tissue adhesives in the operating room/theatre where surgeons are using them increasingly for the closure of surgical skin incisions. Objectives To determine the effects of various tissue adhesives compared with conventional skin closure techniques for the closure of surgical wounds. Search methods In March 2014 for this second update we searched the Cochrane Wounds Group Specialised Register; The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library); Ovid MEDLINE; Ovid MEDLINE (In-Process & Other Non-Indexed Citations); Ovid EMBASE and EBSCO CINAHL. We did not restrict the search and study selection with respect to language, date of publication or study setting. Selection criteria Only randomised controlled trials were eligible for inclusion. Data collection and analysis We conducted screening of eligible studies, data extraction and risk of bias assessment independently and in duplicate. We expressed results as random-effects models using mean difference for continuous outcomes and risk ratios (RR) with 95% confidence intervals (CI) for dichotomous outcomes. We investigated
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