Difference between revisions of "Vishvanath"
(Created page with " <span style="line-height:normal">'''<span style="font-size:18.0pt"><span style="font-family:" times="" new="" roman",serif"=""><span style="color:black">No useful evidence th...") |
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| − | <span style="line-height:normal">'''<span style="font-size:18.0pt"><span style="font-family: | + | <span style="line-height:normal">'''<span style="font-size:18.0pt"><span style="font-family:"><span style="color:black">No useful evidence that hyperbaric oxygen influences the outcome of free vascularised flap surgery</span></span></span>'''</span> |
| − | <span style="line-height:normal">'''<span style="font-size:14.0pt"><span style="font-family: | + | <span style="line-height:normal">'''<span style="font-size:14.0pt"><span style="font-family:"><span style="color:black">Clinical Bottom Line:</span></span></span>'''</span> |
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| − | <span style="line-height:normal"><span style="font-size:14.0pt"><span style="font-family: | + | <span style="line-height:normal"><span style="font-size:14.0pt"><span style="font-family:">1. No advantage was evident with the addition of postoperative hyperbaric oxygen</span></span></span> |
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| − | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:"><span style="color:black">Citation/s:</span></span></span>'''<span style="font-size:12.0pt"><span style="font-family:"><span style="color:black">1.Capt Vishvanath G. Hyperbaric oxygen therapy in free flap surgery: is it meaningful?. Medical Journal Armed Forces India. 2011 Jul 1;67(3):253-6.<br/> '''Lead author's name and fax: '''G Vishvanath: caddie_afmc@yahoo.co.in</span></span></span></span> |
| − | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:"><span style="color:black">Three-part Clinical Question:</span></span></span>'''<span style="font-size:12.0pt"><span style="font-family:"><span style="color:black">For patients undergoing vascularised free flap procedures, does the addition of a course of hyperbaric oxygen to the usual care result in any improved outcomes?<br/> '''Search Terms:''' Plastic surgery, free flap, surgical wound healing</span></span></span></span> |
| − | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:"><span style="color:black">The Study:</span></span></span>'''<span style="font-size:12.0pt"><span style="font-family:"><span style="color:black">Non-blinded randomised controlled trial with intention-to-treat.<br/> '''The Study Patients:''' Patients undergoing free tissue flap procedures with microvascular repair.<br/> '''Control group''' (N = 5; 5 analysed): All usual postoperative care.<br/> '''Experimental group''' (N = 5; 5 analysed): As above but breathed 100% oxygen at 2.5 ATA daily for seven days postoperatively.</span></span></span></span> |
| − | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:"><span style="color:black">The Evidence:</span></span></span>'''</span> |
{| class="Table" style="border:solid windowtext 1.0pt" | {| class="Table" style="border:solid windowtext 1.0pt" | ||
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| − | | style="border:solid windowtext 1.0pt" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | | style="border:solid windowtext 1.0pt" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Outcome</span></span>'''</span></p> |
| − | | style="width:53.15pt; border:solid windowtext 1.0pt" width="73" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | | style="width:53.15pt; border:solid windowtext 1.0pt" width="73" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Time to Outcome</span></span>'''</span></p> |
| − | | style="width:42.5pt; border:solid windowtext 1.0pt" width="59" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | | style="width:42.5pt; border:solid windowtext 1.0pt" width="59" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Control group</span></span>'''</span></p> |
| − | | style="width:46.6pt; border:solid windowtext 1.0pt" width="64" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | | style="width:46.6pt; border:solid windowtext 1.0pt" width="64" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">HBOT group</span></span>'''</span></p> |
| − | | style="width:83.55pt; border:solid windowtext 1.0pt" width="113" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | | style="width:83.55pt; border:solid windowtext 1.0pt" width="113" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Relative risk reduction</span></span>'''</span></p> |
| − | | style="width:76.5pt; border:solid windowtext 1.0pt" width="104" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | | style="width:76.5pt; border:solid windowtext 1.0pt" width="104" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Absolute risk reduction</span></span>'''</span></p> |
| − | | style="width:87.3pt; border:solid windowtext 1.0pt" width="119" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | | style="width:87.3pt; border:solid windowtext 1.0pt" width="119" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">NNT</span></span>'''</span></p> |
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| − | | rowspan="2" style="border:solid windowtext 1.0pt" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | | rowspan="2" style="border:solid windowtext 1.0pt" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Flap loss</span></span>'''</span></p> |
| − | | style="width:53.15pt; border:solid windowtext 1.0pt" width="73" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | style="width:53.15pt; border:solid windowtext 1.0pt" width="73" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">14 days</span></span></span></p> |
| − | | style="width:42.5pt; border:solid windowtext 1.0pt" width="59" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | style="width:42.5pt; border:solid windowtext 1.0pt" width="59" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">0.2</span></span></span></p> |
| − | | style="width:46.6pt; border:solid windowtext 1.0pt" width="64" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | style="width:46.6pt; border:solid windowtext 1.0pt" width="64" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">0.2</span></span></span></p> |
| − | | style="width:83.55pt; border:solid windowtext 1.0pt" width="113" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | style="width:83.55pt; border:solid windowtext 1.0pt" width="113" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">0%</span></span></span></p> |
| − | | style="width:76.5pt; border:solid windowtext 1.0pt" width="104" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | style="width:76.5pt; border:solid windowtext 1.0pt" width="104" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">0.0</span></span></span></p> |
| − | | style="width:87.3pt; border:solid windowtext 1.0pt" width="119" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | style="width:87.3pt; border:solid windowtext 1.0pt" width="119" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">INF</span></span></span></p> |
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| − | | colspan="3" style="width:145.25pt; border:solid windowtext 1.0pt" width="196" | <p align="right" style="margin-bottom:.0001pt; text-align:right; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | colspan="3" style="width:145.25pt; border:solid windowtext 1.0pt" width="196" | <p align="right" style="margin-bottom:.0001pt; text-align:right; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">95% CIs:</span></span></span></p> |
| − | | style="width:83.55pt; border:solid windowtext 1.0pt" width="113" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | style="width:83.55pt; border:solid windowtext 1.0pt" width="113" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">-248% to 100%</span></span></span></p> |
| − | | style="width:76.5pt; border:solid windowtext 1.0pt" width="104" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | style="width:76.5pt; border:solid windowtext 1.0pt" width="104" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">-0.5 to 0.5</span></span></span></p> |
| − | | style="width:87.3pt; border:solid windowtext 1.0pt" width="119" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | style="width:87.3pt; border:solid windowtext 1.0pt" width="119" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">NNT = 2 to INF; NNH = 2 to INF</span></span></span></p> |
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{| class="Table" style="border:solid windowtext 1.0pt" | {| class="Table" style="border:solid windowtext 1.0pt" | ||
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| − | | rowspan="2" style="width:217.25pt; border:solid windowtext 1.0pt" width="293" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | | rowspan="2" style="width:217.25pt; border:solid windowtext 1.0pt" width="293" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Measure</span></span>'''</span></p> |
| − | | colspan="2" style="width:62.25pt; border:solid windowtext 1.0pt" width="85" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | | colspan="2" style="width:62.25pt; border:solid windowtext 1.0pt" width="85" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Control Group</span></span>'''</span></p> |
| − | | colspan="2" style="width:55.2pt; border:solid windowtext 1.0pt" width="76" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | | colspan="2" style="width:55.2pt; border:solid windowtext 1.0pt" width="76" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">HBOT Group</span></span>'''</span></p> |
| − | | rowspan="2" style="width:2.0cm; border:solid windowtext 1.0pt" width="78" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | | rowspan="2" style="width:2.0cm; border:solid windowtext 1.0pt" width="78" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Difference</span></span>'''</span></p> |
| − | | rowspan="2" style="width:50.4pt; border:solid windowtext 1.0pt" width="70" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | | rowspan="2" style="width:50.4pt; border:solid windowtext 1.0pt" width="70" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">95% CI</span></span>'''</span></p> |
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| − | | style="width:41.0pt; border:solid windowtext 1.0pt" width="57" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | style="width:41.0pt; border:solid windowtext 1.0pt" width="57" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">Mean</span></span></span></p> |
| − | | style="width:19.75pt; border:solid windowtext 1.0pt" width="28" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | style="width:19.75pt; border:solid windowtext 1.0pt" width="28" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">SD</span></span></span></p> |
| − | | style="width:33.95pt; border:solid windowtext 1.0pt" width="47" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | style="width:33.95pt; border:solid windowtext 1.0pt" width="47" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">Mean</span></span></span></p> |
| − | | style="width:19.75pt; border:solid windowtext 1.0pt" width="28" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | style="width:19.75pt; border:solid windowtext 1.0pt" width="28" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">SD</span></span></span></p> |
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| style="width:217.25pt; border:solid windowtext 1.0pt" width="293" | | | style="width:217.25pt; border:solid windowtext 1.0pt" width="293" | | ||
| − | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Days to resolution of oedema</span></span>'''</span> |
| − | | style="width:41.0pt; border:solid windowtext 1.0pt" width="57" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | style="width:41.0pt; border:solid windowtext 1.0pt" width="57" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">2.5</span></span></span></p> |
| style="width:19.75pt; border:solid windowtext 1.0pt; padding:.75pt .75pt .75pt .75pt" width="28" | | | style="width:19.75pt; border:solid windowtext 1.0pt; padding:.75pt .75pt .75pt .75pt" width="28" | | ||
| − | | style="width:33.95pt; border:solid windowtext 1.0pt" width="47" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | style="width:33.95pt; border:solid windowtext 1.0pt" width="47" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">2.0</span></span></span></p> |
| style="width:19.75pt; border:solid windowtext 1.0pt; padding:.75pt .75pt .75pt .75pt" width="28" | | | style="width:19.75pt; border:solid windowtext 1.0pt; padding:.75pt .75pt .75pt .75pt" width="28" | | ||
| − | | style="width:2.0cm; border:solid windowtext 1.0pt" width="78" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | style="width:2.0cm; border:solid windowtext 1.0pt" width="78" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">0.5</span></span></span></p> |
| − | | style="width:50.4pt; border:solid windowtext 1.0pt" width="70" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | style="width:50.4pt; border:solid windowtext 1.0pt" width="70" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">-</span></span></span></p> |
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| style="width:217.25pt; border:solid windowtext 1.0pt" width="293" | | | style="width:217.25pt; border:solid windowtext 1.0pt" width="293" | | ||
| − | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Days to resolution of venous congestion</span></span>'''</span> |
| − | | style="width:41.0pt; border:solid windowtext 1.0pt" width="57" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | style="width:41.0pt; border:solid windowtext 1.0pt" width="57" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">0.5</span></span></span></p> |
| style="width:19.75pt; border:solid windowtext 1.0pt; padding:.75pt .75pt .75pt .75pt" width="28" | | | style="width:19.75pt; border:solid windowtext 1.0pt; padding:.75pt .75pt .75pt .75pt" width="28" | | ||
| − | | style="width:33.95pt; border:solid windowtext 1.0pt" width="47" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | style="width:33.95pt; border:solid windowtext 1.0pt" width="47" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">0.25</span></span></span></p> |
| style="width:19.75pt; border:solid windowtext 1.0pt; padding:.75pt .75pt .75pt .75pt" width="28" | | | style="width:19.75pt; border:solid windowtext 1.0pt; padding:.75pt .75pt .75pt .75pt" width="28" | | ||
| − | | style="width:2.0cm; border:solid windowtext 1.0pt" width="78" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | style="width:2.0cm; border:solid windowtext 1.0pt" width="78" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">0.25</span></span></span></p> |
| − | | style="width:50.4pt; border:solid windowtext 1.0pt" width="70" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | style="width:50.4pt; border:solid windowtext 1.0pt" width="70" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">-</span></span></span></p> |
|- | |- | ||
| style="width:217.25pt; border:solid windowtext 1.0pt" width="293" | | | style="width:217.25pt; border:solid windowtext 1.0pt" width="293" | | ||
| − | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Days to complete epithelialisation</span></span>'''</span> |
| − | | style="width:41.0pt; border:solid windowtext 1.0pt" width="57" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | style="width:41.0pt; border:solid windowtext 1.0pt" width="57" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">8.75</span></span></span></p> |
| style="width:19.75pt; border:solid windowtext 1.0pt; padding:.75pt .75pt .75pt .75pt" width="28" | | | style="width:19.75pt; border:solid windowtext 1.0pt; padding:.75pt .75pt .75pt .75pt" width="28" | | ||
| − | | style="width:33.95pt; border:solid windowtext 1.0pt" width="47" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | style="width:33.95pt; border:solid windowtext 1.0pt" width="47" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">8.5</span></span></span></p> |
| style="width:19.75pt; border:solid windowtext 1.0pt; padding:.75pt .75pt .75pt .75pt" width="28" | | | style="width:19.75pt; border:solid windowtext 1.0pt; padding:.75pt .75pt .75pt .75pt" width="28" | | ||
| − | | style="width:2.0cm; border:solid windowtext 1.0pt" width="78" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | style="width:2.0cm; border:solid windowtext 1.0pt" width="78" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">0.25</span></span></span></p> |
| − | | style="width:50.4pt; border:solid windowtext 1.0pt" width="70" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | style="width:50.4pt; border:solid windowtext 1.0pt" width="70" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">-</span></span></span></p> |
|} | |} | ||
| − | + | <span style="font-size:medium;"><span style="line-height:normal">'''<span style="color:black">Comments:</span>'''<br/> <span style="color:black">1. Very small study with low power to detect important differences. Authors made conclusions without any statistical analysis. No description of sample size calculation.<br/> 2. It is not clear if the surgeons were aware of allocation at the time of surgery.<br/> 3. One participant in each group was excluded because of gross flap failure within 24 hours (before any HBO administered).</span></span></span> | |
| − | + | <span style="font-size:medium;"><span style="line-height:normal">'''<span style="color:black">Appraised by: </span>'''<span style="color:black">Mike Bennett POWH m.bennett@unsw.edu.au; Wednesday, 29 September 2021<br/> '''Kill or Update By:''' September 2025</span></span></span> | |
| + | <p style="text-align: center;"> </p> <p style="text-align: center;">[[File:Sumhorsa.gif|center|Sumhorsa.gif]]</p> | ||
| + | = [[Flaps_and_grafts|'''BACK''']] = | ||
Revision as of 00:17, 29 September 2021
No useful evidence that hyperbaric oxygen influences the outcome of free vascularised flap surgery
Clinical Bottom Line:
|
1. No advantage was evident with the addition of postoperative hyperbaric oxygen |
Citation/s:1.Capt Vishvanath G. Hyperbaric oxygen therapy in free flap surgery: is it meaningful?. Medical Journal Armed Forces India. 2011 Jul 1;67(3):253-6.
Lead author's name and fax: G Vishvanath: caddie_afmc@yahoo.co.in
Three-part Clinical Question:For patients undergoing vascularised free flap procedures, does the addition of a course of hyperbaric oxygen to the usual care result in any improved outcomes?
Search Terms: Plastic surgery, free flap, surgical wound healing
The Study:Non-blinded randomised controlled trial with intention-to-treat.
The Study Patients: Patients undergoing free tissue flap procedures with microvascular repair.
Control group (N = 5; 5 analysed): All usual postoperative care.
Experimental group (N = 5; 5 analysed): As above but breathed 100% oxygen at 2.5 ATA daily for seven days postoperatively.
The Evidence:
Outcome |
Time to Outcome |
Control group |
HBOT group |
Relative risk reduction |
Absolute risk reduction |
NNT |
Flap loss |
14 days |
0.2 |
0.2 |
0% |
0.0 |
INF |
95% CIs: |
-248% to 100% |
-0.5 to 0.5 |
NNT = 2 to INF; NNH = 2 to INF | |||
Measure |
Control Group |
HBOT Group |
Difference |
95% CI | ||
Mean |
SD |
Mean |
SD | |||
|
Days to resolution of oedema |
2.5 |
2.0 |
0.5 |
- | ||
|
Days to resolution of venous congestion |
0.5 |
0.25 |
0.25 |
- | ||
|
Days to complete epithelialisation |
8.75 |
8.5 |
0.25 |
- | ||
Comments:
1. Very small study with low power to detect important differences. Authors made conclusions without any statistical analysis. No description of sample size calculation.
2. It is not clear if the surgeons were aware of allocation at the time of surgery.
3. One participant in each group was excluded because of gross flap failure within 24 hours (before any HBO administered).
Appraised by: Mike Bennett POWH m.bennett@unsw.edu.au; Wednesday, 29 September 2021
Kill or Update By: September 2025
