Frontiers in Surgery· 2026Q2· Derleme
Total kalça ve diz protezi ameliyatlarında perioperatif kan yönetimi için topikal oksitlenmiş rejenere selüloz: sistematik derleme ve meta-analiz
Topical oxidized regenerated cellulose for perioperative blood management in total hip and knee arthroplasty: a systematic review and meta-analysis
- 0atıf
- Q2SCImago
- 2026yıl
Kısa özet
Oksitlenmiş rejenere selüloz (ORC), kalça/diz protezi hastalarında ORC kullanılmayan duruma kıyasla kanama ile ilgili sonuçları (toplam perioperatif kayıp: -124.77 mL; hemoglobin düşüşü: -0.57 g/dL) mütevazı ölçüde azaltmıştır (11 çalışma).
Yapay zekâ ile başlık ve abstract'tan üretildi; tam metin okunmaz.
Ana noktalar
- ORC, kalça/diz protezi hastalarında (ORC kullanılmayan/standart bakıma kıyasla) toplam perioperatif kan kaybını 124.77 mL azalttı.
- ORC, ORC kullanılmayan/standart bakıma kıyasla hemoglobin düşüşünü 0.57 g/dL azalttı.
- İntraoperatif kan kaybı, transfüzyon oranları veya genel komplikasyonlar açısından anlamlı fark bulunamadı.
- ORC, aktif topikal karşılaştırıcılara göre belirgin bir avantaj göstermedi.
- ORC artı TXA'ya karşı sadece TXA tek başına kullanımına ilişkin kanıtlar keşif amaçlıydı (tek çalışma).
Yapay zekâ ile başlık ve abstract'tan üretildi; tam metin okunmaz.
Özet (abstract)
Background Total hip arthroplasty (THA) and total knee arthroplasty (TKA) are established procedures for end-stage joint disease, but perioperative blood loss remains a practical concern. Oxidized regenerated cellulose (ORC) has been used as a local hemostatic material during arthroplasty; however, its comparative value in contemporary blood-management protocols remains uncertain. Methods PubMed, Embase, the Cochrane Library, and Scopus were searched from inception to March 2026. Randomized controlled trials and comparative observational studies were eligible if they evaluated ORC in THA or TKA and reported blood-loss-related or complication-related outcomes. Continuous outcomes were pooled as mean differences (MDs), and dichotomous outcomes as risk ratios (RRs), with 95% confidence intervals (CIs). Random-effects models were used. Results Eleven studies were included. Compared with no ORC or standard care, ORC was associated with lower total perioperative blood loss (MD = −124.77 mL, 95% CI −181.71 to −67.83; P < 0.0001), postoperative or hidden blood loss (MD = −136.54 mL, 95% CI −214.97 to −58.10; P = 0.0006), and hemoglobin drop/loss (MD = −0.57 g/dL, 95% CI −0.81 to −0.34; P < 0.00001). No significant differences were found for intraoperative blood loss, transfusion rate, thrombotic events, or overall complications. Compared with active topical comparators, ORC showed no clear advantage. Evidence for ORC plus TXA vs. TXA alone was based on a single study and should be interpreted as exploratory. These effects mainly represent surrogate outcomes rather than definitive patient-important benefits. Conclusions ORC may modestly reduce blood-loss-related surrogate outcomes when compared with no ORC or standard care. Current evidence does not show clear superiority over active topical comparators or establish definite incremental benefit in TXA-based protocols. Because overall certainty remains limited, routine ORC use in unselected arthroplasty patients is not supported; future trials should focus on patient-important outcomes. Registration PROSPERO registration number: CRD420261384870.
Yazarların özeti; kaynağından alınmıştır. Frontiers in Surgery, 2026 · DOI ↗
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