A systematic review of systematic reviews and panoramic meta-analysis: staples versus sutures for surgical procedures.
OBJECTIVE:To systematically evaluate the evidence across surgical specialties as to whether staples or sutures better improve patient and provider level outcomes. DESIGN:A systematic review of systematic reviews and panoramic meta-analysis of pooled estimates. RESULTS:Eleven systematic reviews, incl...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2013-01-01
|
| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC3792070?pdf=render |
| _version_ | 1818945858503180288 |
|---|---|
| author | Karla Hemming Thomas Pinkney Kay Futaba Mary Pennant Dion G Morton Richard J Lilford |
| author_facet | Karla Hemming Thomas Pinkney Kay Futaba Mary Pennant Dion G Morton Richard J Lilford |
| author_sort | Karla Hemming |
| collection | DOAJ |
| description | OBJECTIVE:To systematically evaluate the evidence across surgical specialties as to whether staples or sutures better improve patient and provider level outcomes. DESIGN:A systematic review of systematic reviews and panoramic meta-analysis of pooled estimates. RESULTS:Eleven systematic reviews, including 13,661 observations, met the inclusion criteria. In orthopaedic surgery sutures were found to be preferable, and for appendicial stump sutures were protective against both surgical site infection and post surgical complications. However, staples were protective against leak in ilecolic anastomosis. For all other surgery types the evidence was inconclusive with wider confidence intervals including the possibly of preferential outcomes for surgical site infection or post surgical complication for either staples or sutures. Whilst reviews showed substantial variation in mean differences in operating time (I(2) 94%) there was clear evidence of a reduction in average operating time across all surgery types. Few reviews reported on length of stay, but the three reviews that did (I(2) 0%, including 950 observations) showed a non significant reduction in length of stay, but showed evidence of publication bias (P-value for Egger test 0.05). CONCLUSIONS:Evidence across surgical specialties indicates that wound closure with staples reduces the mean operating time. Despite including several thousand observations, no clear evidence of superiority emerged for either staples or sutures with respect to surgical site infection, post surgical complications, or length of stay. |
| first_indexed | 2024-12-20T08:05:48Z |
| format | Article |
| id | doaj.art-a8a9429b32af4cc29f5bb9ac6469caf2 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-20T08:05:48Z |
| publishDate | 2013-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-a8a9429b32af4cc29f5bb9ac6469caf22022-12-21T19:47:25ZengPublic Library of Science (PLoS)PLoS ONE1932-62032013-01-01810e7513210.1371/journal.pone.0075132A systematic review of systematic reviews and panoramic meta-analysis: staples versus sutures for surgical procedures.Karla HemmingThomas PinkneyKay FutabaMary PennantDion G MortonRichard J LilfordOBJECTIVE:To systematically evaluate the evidence across surgical specialties as to whether staples or sutures better improve patient and provider level outcomes. DESIGN:A systematic review of systematic reviews and panoramic meta-analysis of pooled estimates. RESULTS:Eleven systematic reviews, including 13,661 observations, met the inclusion criteria. In orthopaedic surgery sutures were found to be preferable, and for appendicial stump sutures were protective against both surgical site infection and post surgical complications. However, staples were protective against leak in ilecolic anastomosis. For all other surgery types the evidence was inconclusive with wider confidence intervals including the possibly of preferential outcomes for surgical site infection or post surgical complication for either staples or sutures. Whilst reviews showed substantial variation in mean differences in operating time (I(2) 94%) there was clear evidence of a reduction in average operating time across all surgery types. Few reviews reported on length of stay, but the three reviews that did (I(2) 0%, including 950 observations) showed a non significant reduction in length of stay, but showed evidence of publication bias (P-value for Egger test 0.05). CONCLUSIONS:Evidence across surgical specialties indicates that wound closure with staples reduces the mean operating time. Despite including several thousand observations, no clear evidence of superiority emerged for either staples or sutures with respect to surgical site infection, post surgical complications, or length of stay.http://europepmc.org/articles/PMC3792070?pdf=render |
| spellingShingle | Karla Hemming Thomas Pinkney Kay Futaba Mary Pennant Dion G Morton Richard J Lilford A systematic review of systematic reviews and panoramic meta-analysis: staples versus sutures for surgical procedures. PLoS ONE |
| title | A systematic review of systematic reviews and panoramic meta-analysis: staples versus sutures for surgical procedures. |
| title_full | A systematic review of systematic reviews and panoramic meta-analysis: staples versus sutures for surgical procedures. |
| title_fullStr | A systematic review of systematic reviews and panoramic meta-analysis: staples versus sutures for surgical procedures. |
| title_full_unstemmed | A systematic review of systematic reviews and panoramic meta-analysis: staples versus sutures for surgical procedures. |
| title_short | A systematic review of systematic reviews and panoramic meta-analysis: staples versus sutures for surgical procedures. |
| title_sort | systematic review of systematic reviews and panoramic meta analysis staples versus sutures for surgical procedures |
| url | http://europepmc.org/articles/PMC3792070?pdf=render |
| work_keys_str_mv | AT karlahemming asystematicreviewofsystematicreviewsandpanoramicmetaanalysisstaplesversussuturesforsurgicalprocedures AT thomaspinkney asystematicreviewofsystematicreviewsandpanoramicmetaanalysisstaplesversussuturesforsurgicalprocedures AT kayfutaba asystematicreviewofsystematicreviewsandpanoramicmetaanalysisstaplesversussuturesforsurgicalprocedures AT marypennant asystematicreviewofsystematicreviewsandpanoramicmetaanalysisstaplesversussuturesforsurgicalprocedures AT diongmorton asystematicreviewofsystematicreviewsandpanoramicmetaanalysisstaplesversussuturesforsurgicalprocedures AT richardjlilford asystematicreviewofsystematicreviewsandpanoramicmetaanalysisstaplesversussuturesforsurgicalprocedures AT karlahemming systematicreviewofsystematicreviewsandpanoramicmetaanalysisstaplesversussuturesforsurgicalprocedures AT thomaspinkney systematicreviewofsystematicreviewsandpanoramicmetaanalysisstaplesversussuturesforsurgicalprocedures AT kayfutaba systematicreviewofsystematicreviewsandpanoramicmetaanalysisstaplesversussuturesforsurgicalprocedures AT marypennant systematicreviewofsystematicreviewsandpanoramicmetaanalysisstaplesversussuturesforsurgicalprocedures AT diongmorton systematicreviewofsystematicreviewsandpanoramicmetaanalysisstaplesversussuturesforsurgicalprocedures AT richardjlilford systematicreviewofsystematicreviewsandpanoramicmetaanalysisstaplesversussuturesforsurgicalprocedures |