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<p>Thyroidectomy is a commonly performed surgical procedure, and it is essential to optimize operative techniques to minimize the postoperative complications. The role of platysma muscle layer closure during thyroidectomy remains controversial, and this systematic review and meta-analysis aims to evaluate the postoperative outcomes of platysma closure versus non-closure during thyroidectomy using evidence from randomized controlled trials. To compare the postoperative outcomes of platysma closure vs. non-closure during thyroidectomy. A systematic literature search was conducted on PubMed, Cochrane, ClinicalTrials.gov, Embase, Scopus, and Google Scholar from inception till December 2025. Outcomes included mean postoperative pain, patient scar assessment scale, observer scar assessment scale, length of scar, seroma or hematoma, and wound infection. We employed risk ratios (RRs) with 95% confidence intervals (CIs) for dichotomous outcomes. Mean differences (MDs) or standardized mean differences (SMDs) with 95% CIs were computed for continuous outcomes. Quality assessment and risk of bias were assessed using the Cochrane Risk of Bias Tool 2 on all included RCTs. This systematic review and meta-analysis included 6 RCTs with a total of 566 patients. The non-closure group showed significant improvement in the postoperative pain as compared to the closure group (MD = 1.12; 95% CI: [0.66, 1.58]; <i>p</i> &lt; 0.00001). However, there are no statistically significant differences in other outcomes such as observer scar assessment scale (SMD = 0.25; 95% CI: [-0.27, 0.78]; <i>p</i> = 0.35), patient scar assessment scale (SMD= -0.20; 95% CI: [-0.56, 0.15]; <i>p</i> = 0.26), length of scar (SMD = 0.22; 95% CI: [-0.08, -0.52]; <i>p</i> = 0.15), seroma or hematoma (RR = 3; 95% CI: [0.49, 18.55]; <i>p</i> = 0.24), and wound infection (RR = 0.63; 95% CI: [0.13, 3.16]; <i>p</i> = 0.57). Our study indicates that closing the platysma muscle layer during thyroidectomy may be associated with greater postoperative pain while having no significant effect on scar appearance and other postoperative outcomes.</p>

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Platysma Closure vs. Nonclosure on Post-thyroidectomy Outcomes: A Systematic Review and Updated Meta-analysis of Randomized Controlled Trials

  • 期刊论文

  • 发表日期：

    2026年4月1日

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  • Fatima Tu Zahra,
  • Fahad Amin,
  • Taimoor Hassan,
  • Zainab Saleem,
  • Huzaifa Nadeem,
  • Waleeja Rehaam,
  • Atiqa Noor,
  • Ayesha Ejaz,
  • Waleed Ahmad Khan

摘要

Thyroidectomy is a commonly performed surgical procedure, and it is essential to optimize operative techniques to minimize the postoperative complications. The role of platysma muscle layer closure during thyroidectomy remains controversial, and this systematic review and meta-analysis aims to evaluate the postoperative outcomes of platysma closure versus non-closure during thyroidectomy using evidence from randomized controlled trials. To compare the postoperative outcomes of platysma closure vs. non-closure during thyroidectomy. A systematic literature search was conducted on PubMed, Cochrane, ClinicalTrials.gov, Embase, Scopus, and Google Scholar from inception till December 2025. Outcomes included mean postoperative pain, patient scar assessment scale, observer scar assessment scale, length of scar, seroma or hematoma, and wound infection. We employed risk ratios (RRs) with 95% confidence intervals (CIs) for dichotomous outcomes. Mean differences (MDs) or standardized mean differences (SMDs) with 95% CIs were computed for continuous outcomes. Quality assessment and risk of bias were assessed using the Cochrane Risk of Bias Tool 2 on all included RCTs. This systematic review and meta-analysis included 6 RCTs with a total of 566 patients. The non-closure group showed significant improvement in the postoperative pain as compared to the closure group (MD = 1.12; 95% CI: [0.66, 1.58]; p < 0.00001). However, there are no statistically significant differences in other outcomes such as observer scar assessment scale (SMD = 0.25; 95% CI: [-0.27, 0.78]; p = 0.35), patient scar assessment scale (SMD= -0.20; 95% CI: [-0.56, 0.15]; p = 0.26), length of scar (SMD = 0.22; 95% CI: [-0.08, -0.52]; p = 0.15), seroma or hematoma (RR = 3; 95% CI: [0.49, 18.55]; p = 0.24), and wound infection (RR = 0.63; 95% CI: [0.13, 3.16]; p = 0.57). Our study indicates that closing the platysma muscle layer during thyroidectomy may be associated with greater postoperative pain while having no significant effect on scar appearance and other postoperative outcomes.