Difference between revisions of "Ersoz"
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| − | <span style="font-size: | + | <span style="font-size:xx-large;"><span style="line-height:normal">'''<span style="background:white"><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> |
<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>''' | <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>''' | ||
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<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> | <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> | ||
| − | & | + | <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> |
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<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="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> | ||
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<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="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="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="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="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> | + | <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="color:black">The Evidence:</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="color:black">The Evidence:</span></span></span>'''</span></span> | ||
| − | {| align="left" class="Table" style="border:solid windowtext | + | {| align="left" class="Table" style="border: 1pt solid windowtext; margin-left: 6.75pt; margin-right: 6.75pt; width: 638px;" |
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| − | | rowspan="2" style="width: | + | | rowspan="2" style="width: 138px; border: 1pt solid windowtext;" 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:">Measure</span></span>'''</span></p> |
| − | | colspan="2" style="width: | + | | colspan="2" style="width: 131px; border: 1pt solid windowtext;" 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:">Control Group</span></span>'''</span></p> |
| − | | colspan="2" style="width: | + | | colspan="2" style="width: 146px; border: 1pt solid windowtext;" 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:">HBOT Group</span></span>'''</span></p> |
| − | | rowspan="2" style="width: | + | | rowspan="2" style="width: 88px; border: 1pt solid windowtext;" 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:">Difference</span></span>'''</span></p> |
| − | | rowspan="2" style="border:solid windowtext | + | | rowspan="2" style="border: 1pt solid windowtext; width: 95px;" | <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: | + | | style="width: 59px; border: 1pt solid windowtext;" 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: | + | | style="width: 65px; border: 1pt solid windowtext;" 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:">SD</span></span>'''</span></p> |
| − | | style="width: | + | | style="width: 63px; border: 1pt solid windowtext;" 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:">Mean</span></span>'''</span></p> |
| − | | style="width: | + | | style="width: 76px; border: 1pt solid windowtext;" 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:">SD</span></span>'''</span></p> |
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| − | | style="width: | + | | style="width: 138px; border: 1pt solid windowtext;" width="132" | |
<span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Days to complete epithelialisation</span></span>'''</span> | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Days to complete epithelialisation</span></span>'''</span> | ||
| − | | style="width: | + | | style="width: 59px; border: 1pt solid windowtext;" 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:">83</span></span></span></p> |
| − | | style="width: | + | | style="width: 65px; border: 1pt solid windowtext;" 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:">18</span></span></span></p> |
| − | | style="width: | + | | style="width: 63px; border: 1pt solid windowtext;" 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:">50</span></span></span></p> |
| − | | style="width: | + | | style="width: 76px; border: 1pt solid windowtext;" 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:">11</span></span></span></p> |
| − | | style="width: | + | | style="width: 88px; border: 1pt solid windowtext;" 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:">33</span></span></span></p> |
| − | | style="border:solid windowtext | + | | style="border: 1pt solid windowtext; width: 95px;" | <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:">-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="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="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> |
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| + | <span style="font-size:medium;"><span style="line-height:normal"><span style="background:white"><span style="font-family:"><span style="color:black">'''Kill or Update By: '''November 2023 </span></span></span></span></span> | ||
| + | <p style="text-align: center;"> </p> <p style="text-align: center;">[[File:Sumhorsa.gif|center|Sumhorsa.gif]]</p> <p style="text-align: center;"> </p> <p style="text-align: center;"><span style="font-size:xx-large;">[[Flaps_and_grafts|'''BACK''']]</span></p> | ||
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Latest revision as of 03:52, 17 August 2022
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
Kill or Update By: November 2023
