Insulin and hypertonic glucose in the management of aseptic fat liquefaction of post-surgical incision: a meta-analysis and systematic review.
A meta-analysis and systematic review assessing randomised controlled trials (RCTs) was sought to determine whether subcutaneous injection of insulin with hypertonic glucose promotes healing in postoperative incisions with aseptic fat liquefaction. We searched the Cochrane library, Pubmed, EMBASE, National Science Digital Library (NSDL) and China Biological Medicine Database (CBMdisc) for literature published from 1 January 1990 to 30 September 2011. RCTs that evaluated subcutaneous injection of insulin with hypertonic glucose as a treatment for postoperative wound with fat liquefaction were sought. Wound healing was the primary endpoint. Jadad score and Cochrane Collaboration's tool were used for assessing quality of studies and risk of bias. We abstracted data regarding time to wound healing, cost and adverse effects. The random-effects inverse variance model was used for all analyses using weighted mean difference and 95% confidence interval. Eight trials (414 participants) were identified that met the inclusion criteria. Subcutaneous injection of insulin with hypertonic glucose significantly reduces time to healing by 6·33 days compared with conventional drainage, with less cost. There was no report concerning adverse effects. Subcutaneous injection of insulin with hypertonic glucose may improve the healing process in postoperative wounds with aseptic fat liquefaction.
Department of Cancer Biology, Thomas Jefferson University, Philadelphia, PA 19107, USA. zhongjie.shi@jefferson.edu
Zhongjie
Z
Shi
Lin
L
Ma
Hao
H
Wang
Yuebo
Y
Yang
Xiaomao
X
Li
Ann
A
Schreiber
Wenjing
W
Sun
Zhanliang
Z
Hu
Yuhua
Y
Xue
Jiafeng
J
Teng
Xuan
X
Zhao
Wenli
W
Lu
D003362:Cost-Benefit Analysis; D004338:Drug Combinations; D005218:Fat Necrosis / Q000188:drug therapy*; D005950:Glucose Solution, Hypertonic / Q000008:administration & dosage* / Q000009:adverse effects / Q000191:economics; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000191:economics; D007279:Injections, Subcutaneous; D007328:Insulin / Q000008:administration & dosage* / Q000009:adverse effects / Q000191:economics; D011183:Postoperative Complications / Q000188:drug therapy*; D016032:Randomized Controlled Trials as Topic; D014945:Wound Healing / Q000187:drug effects; D014947:Wounds and Injuries / Q000188:drug therapy*
D004338:Drug Combinations; D005950:Glucose Solution, Hypertonic; D007004:Hypoglycemic Agents; D007328:Insulin