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Revisiting the Role of Pressure Dressing After Otologic Surgery: A Systematic Review and Meta-Analysis
Pey-Yu Chen1,2,3, Che-Yi Lin4, Harrison W Lin3
1Department of Otorhinolaryngology-Head and Neck Surgery, MacKay Memorial Hospital, Taipei, Taiwan.
Objective:
To evaluate the effectiveness of pressure dressing after otologic surgery for evidence-based postoperative care.
Databases Reviewed:
PubMed, Embase, Cochrane Library, EBSCOhost, and Airiti Library.
Methods:
Abstracts compared patients with and without pressure dressing after otologic surgery and reported postoperative surgical site outcomes. The number of operated ears and complication events in each group [pressure dressing (PD) vs. nonpressure dressing (NPD)] was extracted. The selected effect measure for complications was the Peto odds ratio (OR). Effect estimates from individual studies were pooled using the DerSimonian and Laird random-effects model. Subgroup analyses were performed using a mixed-effects model.
Results:
A total of 1358 operated ears from 11 studies were included, including 9 complications eligible for meta-analysis. The odds of hematoma/seroma did not differ between groups. The PD group had significantly higher odds of 3 complications: auricular bruising (1.8% [4/227] vs. 0% [0/223]; odds ratio [OR]: 7.34, 95% CI: 1.03-52.28; I2=0%), dress-related headache (31.3% [25/80] vs. 9.0% [8/89]; OR: 5.61, 95% CI: 2.44-12.92; I2=0%), and skin erythema (20.9% [76/363] vs. 0.6% [2/336]; OR: 8.44, 95% CI: 4.54-15.69; I2=4.6%).
Conclusions:
PD was associated with increased odds of minor complications (skin erythema, auricular bruising, and pain) without reducing hematoma/seroma, suggesting that routine use of PD after otologic surgery may be unnecessary with adequate hemostasis.