Difference between revisions of "Ersoz"
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| − | <span style="font-size:x-large;"><span style="line-height:normal">'''<span style="background:white"><span style="font-family: | + | <span style="font-size:x-large;"><span style="line-height:normal">'''<span style="background:white"><span style="font-family:"><span style="color:black">Clinically important but not statistically significant reduction in the days to heal an open wound following pilonidal sinus excision with the addition of hyperbaric oxygen</span></span></span>'''</span></span> |
| − | <br/> '''<span style="background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;"><span style="font-family: | + | <br/> '''<span style="background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;"><span style="font-family:"><span style="color:black"><span style="font-size:large;">Clinical Bottom Line:</span></span></span></span>''' |
| − | <span style="font-size:medium;"><span style="line-height:normal"><span style="background:white"><span style="font-family: | + | <span style="font-size:medium;"><span style="line-height:normal"><span style="background:white"><span style="font-family:"><span style="color:black">1. Apparent acceleration in time to epithelialisation but not statistically significant.</span></span></span></span></span> |
| − | <span style="font-size:medium;"><span style="line-height:normal"><span style="background:white"><span style="font-family: | + | <span style="font-size:medium;"><span style="line-height:normal"><span style="background:white"><span style="font-family:"><span style="color:black">2. Trend to reduced period of time when symptoms that lead to complaints to the treating team.</span></span></span></span></span> |
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| − | <span style="font-size:medium;"><span style="line-height:normal">'''<span style="background:white"><span style="font-family: | + | <span style="font-size:medium;"><span style="line-height:normal">'''<span style="background:white"><span style="font-family:"><span style="color:black">Citation/s:</span></span></span>'''<span style="background:white"><span style="font-family:"><span style="color:black">1. Ersoz F, Arikan S, Sari S, Korpinar S, Ozcan O, Poyraz B, Purisa S, Toklu AS. Effect of hyperbaric oxygen treatment on pilonidal disease surgery. Undersea & hyperbaric medicine: journal of the Undersea and Hyperbaric Medical Society, Inc. 2016 Nov 1;43(7):821-5</span></span></span></span></span> |
| − | <span style="font-size:medium;"><span style="line-height:normal">'''<span style="background:white"><span style="font-family: | + | <span style="font-size:medium;"><span style="line-height:normal">'''<span style="background:white"><span style="font-family:"><span style="color:black">Corresponding author's name and fax:</span></span></span>'''<span style="background:white"><span style="font-family:"><span style="color:black">Akin Toklu astoklu@istanbul.edu.tr</span></span></span></span></span> |
| − | '''<span style="background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial; | + | <span style="font-size:medium;">'''<span style="background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;"><span style="color:black">Three-part Clinical Question: </span></span>'''</span><span style="font-size: medium; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;"><span style="font-family:"><span style="color:black">For post-operative adults with surgically excised pilonidal sinus defects left open to heal, does the addition of hyperbaric oxygen to standard care result in accelerated healing?</span></span></span> |
| − | <span style="font-size:medium;"><span style="line-height:normal">'''<span style="background:white"><span style="font-family: | + | <span style="font-size:medium;"><span style="line-height:normal">'''<span style="background:white"><span style="font-family:"><span style="color:black">Search Terms:</span></span></span>'''<span style="background:white"><span style="font-family:"><span style="color:black">Pilonidal sinus surgery; open wound; surgical wound healing</span></span></span></span></span> |
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| − | <span style="font-size:medium;"><span style="line-height:normal">'''<span style="background:white"><span style="font-family: | + | <span style="font-size:medium;"><span style="line-height:normal">'''<span style="background:white"><span style="font-family:"><span style="color:black">The Study:</span></span></span>'''<span style="background:white"><span style="font-family:"><span style="color:black">Single-blinded randomised controlled trial without intention-to-treat.</span></span></span></span></span> |
| − | <span style="font-size:medium;"><span style="line-height:normal">'''<span style="background:white"><span style="font-family: | + | <span style="font-size:medium;"><span style="line-height:normal">'''<span style="background:white"><span style="font-family:"><span style="color:black">The Study Patients:</span></span></span>'''<span style="background:white"><span style="font-family:"><span style="color:black">Adult male patients with pilonidal sinus for surgical excision for the first time. All involved tissue resected and laid open.</span></span></span></span></span> |
| − | <span style="font-size:medium;"><span style="line-height:normal"><span style="background:white"><span style="font-family: | + | <span style="font-size:medium;"><span style="line-height:normal"><span style="background:white"><span style="font-family:"><span style="color:black">Control group (N = 12; 12 analysed): Standard surgical technique and wounds left to heal after being laid open. Daily saline irrigation.</span></span></span></span></span> |
| − | <span style="font-size:medium;"><span style="line-height:normal"><span style="background:white"><span style="font-family: | + | <span style="font-size:medium;"><span style="line-height:normal"><span style="background:white"><span style="font-family:"><span style="color:black">Experimental group (N = 10; 10 analysed): As above with the addition of 18 sessions of 100% oxygen breathing for 90 minutes daily at 2.5 ATA six days each week for three weeks.</span></span></span></span></span> |
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| − | <span style="font-size:medium;"><span style="line-height:normal">'''<span style="background:white"><span style="font-family: | + | <span style="font-size:medium;"><span style="line-height:normal">'''<span style="background:white"><span style="font-family:"><span style="color:black">The Evidence:</span></span></span>'''</span></span> |
| − | + | {| align="left" class="Table" style="border:solid windowtext 1.0pt; margin-left:6.75pt; margin-right:6.75pt" | |
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| − | {| align="left" class="Table" style="margin-left:6.75pt; margin-right:6.75pt | ||
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| − | | rowspan="2" style="width:96.6pt" width="132" | <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:" times="" new="" roman",serif"="">Measure</span></span>'''</span></p> | + | | rowspan="2" style="width:96.6pt; border:solid windowtext 1.0pt" width="132" | <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:" times="" new="" roman",serif"="">Measure</span></span>'''</span></p> |
| − | | colspan="2" style="width:83.55pt" 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:" times="" new="" roman",serif"="">Control Group</span></span>'''</span></p> | + | | colspan="2" 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:" times="" new="" roman",serif"="">Control Group</span></span>'''</span></p> |
| − | | colspan="2" style="width:96.9pt" width="131" | <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:" times="" new="" roman",serif"="">HBOT Group</span></span>'''</span></p> | + | | colspan="2" style="width:96.9pt; border:solid windowtext 1.0pt" width="131" | <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:" times="" new="" roman",serif"="">HBOT Group</span></span>'''</span></p> |
| − | | rowspan="2" style="width:70.65pt" width="96" | <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:" times="" new="" roman",serif"="">Difference</span></span>'''</span></p> | + | | rowspan="2" style="width:70.65pt; border:solid windowtext 1.0pt" width="96" | <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:" times="" new="" roman",serif"="">Difference</span></span>'''</span></p> |
| − | | rowspan="2" | <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:" times="" new="" roman",serif"="">95% CI</span></span>'''</span></p> | + | | 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:" times="" new="" roman",serif"="">95% CI</span></span>'''</span></p> |
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| − | | style="width:41.0pt" 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:" times="" new="" roman",serif"="">Mean</span></span>'''</span></p> | + | | 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:" times="" new="" roman",serif"="">Mean</span></span>'''</span></p> |
| − | | style="width:41.05pt" 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:" times="" new="" roman",serif"="">SD</span></span>'''</span></p> | + | | style="width:41.05pt; 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:" times="" new="" roman",serif"="">SD</span></span>'''</span></p> |
| − | | style="width:48.1pt" width="66" | <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:" times="" new="" roman",serif"="">Mean</span></span>'''</span></p> | + | | style="width:48.1pt; border:solid windowtext 1.0pt" width="66" | <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:" times="" new="" roman",serif"="">Mean</span></span>'''</span></p> |
| − | | style="width:47.3pt" width="65" | <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:" times="" new="" roman",serif"="">SD</span></span>'''</span></p> | + | | style="width:47.3pt; border:solid windowtext 1.0pt" width="65" | <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:" times="" new="" roman",serif"="">SD</span></span>'''</span></p> |
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| − | | style="width:96.6pt" width="132" | | + | | style="width:96.6pt; border:solid windowtext 1.0pt" width="132" | |
<span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">Days to complete epithelialisation</span></span>'''</span> | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">Days to complete epithelialisation</span></span>'''</span> | ||
| − | | style="width:41.0pt" 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:" times="" new="" roman",serif"="">83</span></span></span></p> | + | | 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:" times="" new="" roman",serif"="">83</span></span></span></p> |
| − | | style="width:41.05pt" 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:" times="" new="" roman",serif"="">18</span></span></span></p> | + | | style="width:41.05pt; 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:" times="" new="" roman",serif"="">18</span></span></span></p> |
| − | | style="width:48.1pt" width="66" | <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:" times="" new="" roman",serif"="">50</span></span></span></p> | + | | style="width:48.1pt; border:solid windowtext 1.0pt" width="66" | <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:" times="" new="" roman",serif"="">50</span></span></span></p> |
| − | | style="width:47.3pt" width="65" | <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:" times="" new="" roman",serif"="">11</span></span></span></p> | + | | style="width:47.3pt; border:solid windowtext 1.0pt" width="65" | <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:" times="" new="" roman",serif"="">11</span></span></span></p> |
| − | | style="width:70.65pt" width="96" | <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:" times="" new="" roman",serif"="">33</span></span></span></p> | + | | style="width:70.65pt; border:solid windowtext 1.0pt" width="96" | <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:" times="" new="" roman",serif"="">33</span></span></span></p> |
| − | | <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:" times="" new="" roman",serif"="">-174 to 240</span></span></span></p> | + | | 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:" times="" new="" roman",serif"="">-174 to 240</span></span></span></p> |
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| − | <span style="font-size:medium;"><span style="line-height:normal">'''<span style="background:white"><span style="font-family: | + | <span style="font-size:medium;"><span style="line-height:normal">'''<span style="background:white"><span style="font-family:"><span style="color:black">Comments:</span></span></span>'''</span></span> |
| − | <span style="font-size:medium;"><span style="line-height:normal"><span style="background:white"><span style="font-family: | + | <span style="font-size:medium;"><span style="line-height:normal"><span style="background:white"><span style="font-family:"><span style="color:black">1. Randomisation by shuffling cards. Assessing surgeon from 2 weeks was blinded to allocation</span></span></span></span></span> |
| − | <span style="font-size:medium;"><span style="line-height:normal"><span style="background:white"><span style="font-family: | + | <span style="font-size:medium;"><span style="line-height:normal"><span style="background:white"><span style="font-family:"><span style="color:black">2. No mortality of post-operative complications reported in either group.</span></span></span></span></span> |
| − | <span style="font-size:medium;"><span style="line-height:normal"><span style="background:white"><span style="font-family: | + | <span style="font-size:medium;"><span style="line-height:normal"><span style="background:white"><span style="font-family:"><span style="color:black">3. Authors state that recurrence is the worst feature of this disease after operation, but have not assessed this outcome.</span></span></span></span></span> |
| − | <span style="font-size:medium;"><span style="line-height:normal"><span style="background:white"><span style="font-family: | + | <span style="font-size:medium;"><span style="line-height:normal"><span style="background:white"><span style="font-family:"><span style="color:black">4. Authors report a statistically significant difference in days to epithelialisation using a t-test but this result '''is not''' confirmed by the analysis using our software.</span></span></span></span></span> |
| − | <span style="font-size:medium;"><span style="line-height:normal"><span style="background:white"><span style="font-family: | + | <span style="font-size:medium;"><span style="line-height:normal"><span style="background:white"><span style="font-family:"><span style="color:black">5. Authors also report statistically lower serum albumin in the HBOT group but this does not seem likely to be clinically relevant (4.67 versus 4.31 g/dl).</span></span></span></span></span> |
| − | <span style="font-size:medium;"><span style="line-height:normal"><span style="background:white"><span style="font-family: | + | <span style="font-size:medium;"><span style="line-height:normal"><span style="background:white"><span style="font-family:"><span style="color:black">6. Small trial with low power.</span></span></span></span></span> |
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| − | <span style="font-size:medium;"><span style="line-height:normal">'''<span style="background:white"><span style="font-family: | + | <span style="font-size:medium;"><span style="line-height:normal">'''<span style="background:white"><span style="font-family:"><span style="color:black">Appraised by:</span></span></span>'''<span style="background:white"><span style="font-family:"><span style="color:black">Mike Bennett m.bennett@unsw.edu.au ; Thursday, 12 November 2020</span></span></span></span></span> |
| − | <span style="font-size:medium;"><span style="line-height:normal"><span style="background:white"><span style="font-family: | + | <span style="font-size:medium;"><span style="line-height:normal"><span style="background:white"><span style="font-family:"><span style="color:black">Email: Kill or Update By: November 2023 501133-174.216 to 240.216</span></span></span></span></span> |
Revision as of 02:54, 12 November 2020
Clinically important but not statistically significant reduction in the days to heal an open wound following pilonidal sinus excision with the addition of hyperbaric oxygen
Clinical Bottom Line:
1. Apparent acceleration in time to epithelialisation but not statistically significant.
2. Trend to reduced period of time when symptoms that lead to complaints to the treating team.
Citation/s:1. Ersoz F, Arikan S, Sari S, Korpinar S, Ozcan O, Poyraz B, Purisa S, Toklu AS. Effect of hyperbaric oxygen treatment on pilonidal disease surgery. Undersea & hyperbaric medicine: journal of the Undersea and Hyperbaric Medical Society, Inc. 2016 Nov 1;43(7):821-5
Corresponding author's name and fax:Akin Toklu astoklu@istanbul.edu.tr
Three-part Clinical Question: For post-operative adults with surgically excised pilonidal sinus defects left open to heal, does the addition of hyperbaric oxygen to standard care result in accelerated healing?
Search Terms:Pilonidal sinus surgery; open wound; surgical wound healing
The Study:Single-blinded randomised controlled trial without intention-to-treat.
The Study Patients:Adult male patients with pilonidal sinus for surgical excision for the first time. All involved tissue resected and laid open.
Control group (N = 12; 12 analysed): Standard surgical technique and wounds left to heal after being laid open. Daily saline irrigation.
Experimental group (N = 10; 10 analysed): As above with the addition of 18 sessions of 100% oxygen breathing for 90 minutes daily at 2.5 ATA six days each week for three weeks.
The Evidence:
Measure |
Control Group |
HBOT Group |
Difference |
95% CI | ||
Mean |
SD |
Mean |
SD | |||
|
Days to complete epithelialisation |
83 |
18 |
50 |
11 |
33 |
-174 to 240 |
Comments:
1. Randomisation by shuffling cards. Assessing surgeon from 2 weeks was blinded to allocation
2. No mortality of post-operative complications reported in either group.
3. Authors state that recurrence is the worst feature of this disease after operation, but have not assessed this outcome.
4. Authors report a statistically significant difference in days to epithelialisation using a t-test but this result is not confirmed by the analysis using our software.
5. Authors also report statistically lower serum albumin in the HBOT group but this does not seem likely to be clinically relevant (4.67 versus 4.31 g/dl).
6. Small trial with low power.
Appraised by:Mike Bennett m.bennett@unsw.edu.au ; Thursday, 12 November 2020
Email: Kill or Update By: November 2023 501133-174.216 to 240.216
