Scholarlink

Background <p>To critically appraise the evidence supporting the European and American Hernia Society (EHS/AHS) guidelines on abdominal wall closure in colorectal and emergency surgery patients, we conducted a granular analysis focused on the representation and quality of available data.</p> Methods <p>References that addressed key questions (KQ) and recommendations in the original guidelines were screened and included if colorectal/emergency surgery was reported. Data extraction was performed with a standardised form and authors were contacted for missing data. Quality and risk of bias were assessed independently by two reviewers.</p> Results <p>Out of 33 studies included: 15 systematic reviews and one literature review were rated low or critically low (AMSTAR 2); 12 randomised controlled trials had moderate to high risk of bias (Cochrane RoB-2 tool); five observational studies were of low to very low quality (GRADE) with serious risk of bias (ROBINS-I). 32 studies included colorectal (<i>n</i> = 15,856) and 14 emergency patients (<i>n</i> = 4,582). To answer KQ1 on ‘minimally invasive or open surgery’ and ‘type of incision’ 9/10 studies included colorectal and no studies included emergency patients. 1/4 and 8/9 studies included colorectal/emergency patients for recommendations regarding trocar sites closure (KQ2) and closure after laparotomy (KQ3). Regarding the use of mesh (KQ5), 11/11 studies included colorectal/emergency patients. 3/3 and 1 studies included colorectal patients for KQ6 (abdominal binders) and one for KQ7 (restriction of activity), but none included emergency patients.</p> Conclusion <p>Recommendations for KQs 1, 3, 5, 6, and 7 appear&#xa0;applicable to colorectal patients, whereas evidence for KQ2 remains&#xa0;insufficient. For emergency patients, recommendations related to KQs 1,&#xa0;2, 6, and 7 should not be extrapolated. This study further highlights&#xa0;critical limitations in the evidence base, including the lack of patient-centred&#xa0;outcomes, and underscores the need for targeted, high-quality&#xa0;research in these populations.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Colorectal and emergency surgical patients in the literature supporting EHS and AHS guidelines on abdominal wound closure: a granular analysis

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年10月22日

查看全文
  • Vittoria Bellato,
  • Sue Blackwell,
  • Muhammed Elhadi,
  • Thomas Grove,
  • Lisa Massey,
  • Barbara Vieira,
  • Andreas Denys,
  • Francesco Pata,
  • Gabrielle H. van Ramshorst,
  • Thomas Pinkney,
  • Erman Aytac,
  • Pamela Buchwald,
  • Niki Christou,
  • Dragomir Dardanov,
  • Alaa El-Hussuna,
  • Nir Horesh,
  • Karoline Horisberger,
  • Per Johansson,
  • James Keatley,
  • Yurij Kosir,
  • Hans Lederhuber,
  • Dion Morton,
  • Mostafa Shalaby,
  • Carolynne Vaizey,
  • Patricia Tejedor,
  • Sanjay Chaudhri,
  • Sharfuddin Chowdury,
  • Audrius Dulskas,
  • Caterina Foppa,
  • Matteo Frasson,
  • Gaetano Gallo,
  • James Glasbey,
  • Michael Kelly,
  • Elizabeth Li,
  • Ana Maria Minaya-Bravo,
  • Peter Neary,
  • Ionut Negoi,
  • Gianluca Pellino,
  • Shaji Sebastion,
  • Beatriz Silva Mendes,
  • Baljit Singh,
  • Aya Riad,
  • Niels-Derrek Schmitz,
  • Kerstin Spychaj,
  • Celine Riess,
  • Liza Ovington

摘要

Background

To critically appraise the evidence supporting the European and American Hernia Society (EHS/AHS) guidelines on abdominal wall closure in colorectal and emergency surgery patients, we conducted a granular analysis focused on the representation and quality of available data.

Methods

References that addressed key questions (KQ) and recommendations in the original guidelines were screened and included if colorectal/emergency surgery was reported. Data extraction was performed with a standardised form and authors were contacted for missing data. Quality and risk of bias were assessed independently by two reviewers.

Results

Out of 33 studies included: 15 systematic reviews and one literature review were rated low or critically low (AMSTAR 2); 12 randomised controlled trials had moderate to high risk of bias (Cochrane RoB-2 tool); five observational studies were of low to very low quality (GRADE) with serious risk of bias (ROBINS-I). 32 studies included colorectal (n = 15,856) and 14 emergency patients (n = 4,582). To answer KQ1 on ‘minimally invasive or open surgery’ and ‘type of incision’ 9/10 studies included colorectal and no studies included emergency patients. 1/4 and 8/9 studies included colorectal/emergency patients for recommendations regarding trocar sites closure (KQ2) and closure after laparotomy (KQ3). Regarding the use of mesh (KQ5), 11/11 studies included colorectal/emergency patients. 3/3 and 1 studies included colorectal patients for KQ6 (abdominal binders) and one for KQ7 (restriction of activity), but none included emergency patients.

Conclusion

Recommendations for KQs 1, 3, 5, 6, and 7 appear applicable to colorectal patients, whereas evidence for KQ2 remains insufficient. For emergency patients, recommendations related to KQs 1, 2, 6, and 7 should not be extrapolated. This study further highlights critical limitations in the evidence base, including the lack of patient-centred outcomes, and underscores the need for targeted, high-quality research in these populations.