Abstract

Aims: Wound closure after thyroidectomy and parathyroidectomy is associated with patients’ satisfaction, perception of cosmetic appearance, and experience of postoperative pain. Subcutaneous sutures, clips, and tissue adhesive are the three major methods of wound closure. In this study, we conducted a meta-analysis of randomized controlled trials to evaluate the outcomes of these methods. Methods: Relevant studies published before December 2017 were identified from PubMed, Embase, Cochrane Library, Scopus, and the ClinicalTrials.gov registry. Individual effect sizes were standardized, and a meta-analysis was conducted to calculate the pooled effect size by using random-effect models. The primary outcome was the cosmetic appearance, which was evaluated 4 weeks, 6 weeks, and 6 months after surgery. The secondary outcomes were patient satisfaction, postoperative pain, and complications. Results: A total of nine trials with 612 patients were reviewed. No significant difference was observed in patient satisfaction, postoperative pain, and complications among the wound closure methods. However, according to surgeon assessment, the subcutaneous suture method resulted in a significantly more favorable cosmetic appearance than the clip method (mean difference: −1.47, 95% confidence interval: −2.72 to −0.23). Conclusion: In the current study, no differences were found in patient satisfaction and postoperative pain among the subcutaneous suture, clip, and tissue adhesive wound closure methods. However, surgeons provided a more favorable appraisal for the subcutaneous suture method because of the improved cosmetic appearance. The choice of the closure method should be based on surgeon’s preference and cost.

Original languageEnglish
Pages (from-to)1457496918798203
JournalScandinavian Journal of Surgery
Early online dateSep 6 2018
DOIs
Publication statusE-pub ahead of print - Sep 6 2018

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Meta-Analysis
Thyroid Gland
Randomized Controlled Trials
Wounds and Injuries
Postoperative Pain
Patient Satisfaction
Cosmetics
Sutures
Surgical Instruments
Tissue Adhesives
Parathyroidectomy
Thyroidectomy
PubMed
Libraries
Registries
Confidence Intervals
Costs and Cost Analysis
Surgeons

Keywords

  • Thyroidectomy
  • clip
  • cosmetic appearance
  • meta-analysis
  • pain
  • patient satisfaction
  • subcutaneous suture
  • tissue adhesive

ASJC Scopus subject areas

  • Surgery

Cite this

Wound Closure after Thyroid and Parathyroid Surgery : A Meta-Analysis of Randomized Controlled Trials. / Huang, Y-H; Chen, C; Lee, C-H; Loh, E-W; Tam, K-W.

In: Scandinavian Journal of Surgery, 06.09.2018, p. 1457496918798203.

Research output: Contribution to journalArticle

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abstract = "Aims: Wound closure after thyroidectomy and parathyroidectomy is associated with patients’ satisfaction, perception of cosmetic appearance, and experience of postoperative pain. Subcutaneous sutures, clips, and tissue adhesive are the three major methods of wound closure. In this study, we conducted a meta-analysis of randomized controlled trials to evaluate the outcomes of these methods. Methods: Relevant studies published before December 2017 were identified from PubMed, Embase, Cochrane Library, Scopus, and the ClinicalTrials.gov registry. Individual effect sizes were standardized, and a meta-analysis was conducted to calculate the pooled effect size by using random-effect models. The primary outcome was the cosmetic appearance, which was evaluated 4 weeks, 6 weeks, and 6 months after surgery. The secondary outcomes were patient satisfaction, postoperative pain, and complications. Results: A total of nine trials with 612 patients were reviewed. No significant difference was observed in patient satisfaction, postoperative pain, and complications among the wound closure methods. However, according to surgeon assessment, the subcutaneous suture method resulted in a significantly more favorable cosmetic appearance than the clip method (mean difference: −1.47, 95{\%} confidence interval: −2.72 to −0.23). Conclusion: In the current study, no differences were found in patient satisfaction and postoperative pain among the subcutaneous suture, clip, and tissue adhesive wound closure methods. However, surgeons provided a more favorable appraisal for the subcutaneous suture method because of the improved cosmetic appearance. The choice of the closure method should be based on surgeon’s preference and cost.",
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