Effect of topical nitroglycerin application on flap survival and complications post reconstructive microsurgery: A systematic review and meta-analysis study of the literature
Notice bibliographique
Résumé
Background and Aims: Several methods have been used in plastic and reconstructive surgery to reduce post-surgical complications, such as partial or complete flap loss due to ischemia and necrosis. Nitroglycerine application has been introduced as a viable alternative to papaverine to act as a local vasodilator to improve perfusion and reduce vasospasm. However, the literature has not thoroughly studied its efficacy and administration dose. This systematic review and meta-analysis study has been designed to assess the efficacy of topical nitroglycerine applications in reducing post-surgical flap necrosis and complications. Methods and Materials: A systematic literature search was performed on PubMed, Scopus, and Web of Science from inception to January 2023 with relevant keywords and terms. Case reports, review articles, letters, articles in any language other than English, and animal studies were excluded. The Newcastle-Ottawa and Jadad scales were used to assess the quality of the included studies. The pooled effect sizes were calculated using the random effect model with the Mantel-Haenszel method. Results: Overall, 2031 studies were obtained, among which 454 articles were duplicated and removed. Of the remaining 1577 articles, based on the eligibility and exclusion criteria, 20 articles were retrieved for full-text review. Finally, eight articles were included in our study. Three thousand nine hundred six patients had undergone reconstructive microsurgery and received topical nitroglycerin for the prevention of possible complications. The pooled rate of flap complication was 15% (95% CI: 8% to 25%, I 2 = 96%, p-value < 0.01), and the pooled odds ratio of flap complication was 0.35 (95% CI: 0.15 to 0.83, I 2 = 91%, p-value = 0.02). The heterogeneity of the included studies was significantly high. The dose and regimen of application significantly differed between each study. Conclusion: Topical administration of nitroglycerin compounds post reconstructive microsurgery can reduce the risk of flap necrosis. However, the precise dosage, duration of application, and possible underlying factors affecting drug efficacy are yet to be discovered.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,009 | 0,004 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».