{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T11:51:11Z","timestamp":1773921071580,"version":"3.50.1"},"reference-count":25,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2017,3,2]],"date-time":"2017-03-02T00:00:00Z","timestamp":1488412800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Otolaryngology"],"published-print":{"date-parts":[[2017,12]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Fibrin sealants (<jats:styled-content style=\"fixed-case\">FS<\/jats:styled-content>) are commercially available products used in surgical wounds as adjuncts to haemostasis and closure of dead space. The role of <jats:styled-content style=\"fixed-case\">FS<\/jats:styled-content> in soft tissue head and neck surgery has not been established.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To assess whether <jats:styled-content style=\"fixed-case\">FS<\/jats:styled-content> improves wound\u2010related outcomes in patients undergoing soft tissue surgery of the head and neck anatomical region that would commonly require a drain.<\/jats:p><\/jats:sec><jats:sec><jats:title>Type of review<\/jats:title><jats:p>Systematic review and meta\u2010analysis of randomised controlled trials (<jats:styled-content style=\"fixed-case\">RCT<\/jats:styled-content>s).<\/jats:p><\/jats:sec><jats:sec><jats:title>Search strategy<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">MEDLINE<\/jats:styled-content> (1946\u20102016), <jats:styled-content style=\"fixed-case\">EMBASE<\/jats:styled-content> (1974\u20102016), PubMed (2016), <jats:styled-content style=\"fixed-case\">CENTRAL<\/jats:styled-content> (2016), ClinicalTrials.gov (2016), <jats:styled-content style=\"fixed-case\">WHO<\/jats:styled-content> International Clinical Trials Registry and Platform (2016), Research Gate (2016).<\/jats:p><\/jats:sec><jats:sec><jats:title>Evaluation method<\/jats:title><jats:p>Two independent reviewers screened and selected studies. Included studies were assessed for risk of bias and data extracted using a predetermined data collection form.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 421 studies that were screened, 11 <jats:styled-content style=\"fixed-case\">RCT<\/jats:styled-content>s met the inclusion criteria. There were two <jats:styled-content style=\"fixed-case\">RCT<\/jats:styled-content>s on thyroidectomy, three on \u201csurgery involving neck dissection\u201d (central or lateral), five on rhytidectomy and one on parotidectomy. There was a tendency for <jats:styled-content style=\"fixed-case\">FS<\/jats:styled-content> to reduce \u201cmean total drainage volume\u201d (mean difference \u221226.86\u00a0mL, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> \u221243.41 to \u221210.31, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>=97%, <jats:italic>P<\/jats:italic>=.001). Subgroup analysis of thyroidectomy (mean difference \u221236.36\u00a0mL, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> \u221272.82 to 0.10, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>=79%, <jats:italic>P<\/jats:italic>=.05), \u201csurgery involving neck dissection\u201d (mean difference \u221233.21\u00a0mL, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> \u221270.01 to 3.59, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>=94%, <jats:italic>P<\/jats:italic>=.08) and rhytidectomy (mean difference \u221213.79\u00a0mL, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> \u221217.57 to \u221210.01, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>=0%, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.00001) concurred with the overall analysis. There was a suggestion that <jats:styled-content style=\"fixed-case\">FS<\/jats:styled-content> may reduce \u201cmean retention time of drains\u201d by 1.24\u00a0days (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> \u22123.32 to 0.85, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>=99%, <jats:italic>P<\/jats:italic>=.25) and \u201chospital length of stay\u201d by 2.09\u00a0days (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> \u22125.18 to 0.99, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>=97%, <jats:italic>P<\/jats:italic>=.18), but this was not statistically significant. There was also a suggestion that <jats:styled-content style=\"fixed-case\">FS<\/jats:styled-content> may protect against adverse events (<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content> 0.69, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.35 to 1.38, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>=0%, <jats:italic>P<\/jats:italic>=.29) and haematoma\/seroma formation (<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content> 0.49, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.22 to 1.07, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>=0%, <jats:italic>P<\/jats:italic>=0.07).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>There was considerable heterogeneity within the <jats:styled-content style=\"fixed-case\">RCT<\/jats:styled-content>s included in this study, thus restricting definitive conclusions. <jats:styled-content style=\"fixed-case\">FS<\/jats:styled-content> has however shown a definite benefit in rhytidectomy and potential benefit in other soft tissue head and neck surgical procedures. Further pragmatic trials are required particularly in the field of lateral neck dissection.<\/jats:p><\/jats:sec>","DOI":"10.1111\/coa.12837","type":"journal-article","created":{"date-parts":[[2017,1,28]],"date-time":"2017-01-28T14:46:44Z","timestamp":1485614804000},"page":"1141-1152","source":"Crossref","is-referenced-by-count":32,"title":["Fibrin sealants in soft tissue surgery of the head and neck: A systematic review and meta\u2010analysis of randomised controlled trials"],"prefix":"10.1111","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3135-754X","authenticated-orcid":false,"given":"M.S.","family":"Bajwa","sequence":"first","affiliation":[{"name":"Department of Molecular and Clinical Cancer Medicine Northwest Cancer Research Centre University of Liverpool Liverpool UK"},{"name":"Regional Maxillofacial Unit Aintree University Hospital Liverpool UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.","family":"Tudur\u2010Smith","sequence":"additional","affiliation":[{"name":"Department of Biostatistics University of Liverpool Liverpool UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5157-4042","authenticated-orcid":false,"given":"R.J.","family":"Shaw","sequence":"additional","affiliation":[{"name":"Department of Molecular and Clinical Cancer Medicine Northwest Cancer Research Centre University of Liverpool Liverpool UK"},{"name":"Regional Maxillofacial Unit Aintree University Hospital Liverpool UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9466-6038","authenticated-orcid":false,"given":"A.G.","family":"Schache","sequence":"additional","affiliation":[{"name":"Department of Molecular and Clinical Cancer Medicine Northwest Cancer Research Centre University of Liverpool Liverpool UK"},{"name":"Regional Maxillofacial Unit Aintree University Hospital Liverpool UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,3,2]]},"reference":[{"key":"e_1_2_8_2_1","first-page":"CD009557","article-title":"Fibrin glue instillation under skin flaps to prevent seroma\u2010related morbidity following breast and axillary surgery","volume":"5","author":"Sajid MS","year":"2013","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.9448"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00266-008-9280-1"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/asj\/sju078"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.25256"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000133083.54934.ae"},{"key":"e_1_2_8_8_1","unstructured":"BajwaMS SchacheAG ShawRJ Tudur\u2010SmithC ReyP.Fibrin tissue adhesives for wound healing in soft\u2010tissue surgery of the head and neck.PROSPERO: International Prospective Register of Systematic Reviews. 2016. 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