title: Tissue sealants may reduce haematoma and complications in face-lifts: A meta-analysis of comparative studies.
abstract: The use of tissue sealants has increased among different surgical specialities. Face-lift and rhytidoplasty may cause several complications such as haematoma, ecchymosis, oedema, seroma, skin necrosis, wound dehiscence and wound infection. However, administration of tissue sealants may prevent the occurrence of some complications. We performed a meta-analysis of studies that compared tissue sealant use with controls to evaluate the outcomes. A systematic literature search was performed. The primary outcome was the incidence of haematoma. Secondary outcomes were wound drainage amount, oedema, ecchymosis, seroma, skin necrosis and hypertrophic scarring. Thirteen studies involving 2434 patients were retrieved and included in the present analysis. A statistically significantly decrease in post-operative haematoma [risk ratio (RR), 0.37; 95% CI, 0.18-0.74; p = 0.005] and wound drainage (MD, -16.90, 95% CI = -25.71, -8.08, p < 0.001) was observed with tissue sealant use. A significant decrease in oedema was detected (RR, 0.30; 95% CI, 0.11-0.85, p = 0.02) but not in ecchymosis, seroma, skin necrosis, and hypertrophic scarring with tissue sealant use. The use of tissue sealants prevents post-operative haematomas and reduces wound drainage. Previous studies have shown a similar trend, but the power of this meta-analysis could verify this perception.
  
  
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authors.affiliation: Department of Plastic and General Surgery, Turku University Hospital, Turku, Finland; Department of Surgery, Welfare District of Forssa, Forssa, Finland. Electronic address: salvatore.giordano@gmail.com.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Giordano
authors.affiliation: Department of Plastic and General Surgery, Turku University Hospital, Turku, Finland.
authors.forename: Ilkka
authors.initials: I
authors.lastname: Koskivuo
authors.affiliation: Department of Plastic and General Surgery, Turku University Hospital, Turku, Finland.
authors.forename: Erkki
authors.initials: E
authors.lastname: Suominen
authors.affiliation: Department of Plastic and General Surgery, Turku University Hospital, Turku, Finland.
authors.forename: Esko
authors.initials: E
authors.lastname: Veräjänkorva
mesh_terms: D017439:Cicatrix, Hypertrophic / Q000209:etiology; D004322:Drainage / Q000379:methods; D004438:Ecchymosis / Q000209:etiology; D004487:Edema / Q000209:etiology; D004812:Epidemiologic Methods; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use*; D006406:Hematoma / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D053657:Platelet-Rich Plasma; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control; D015361:Rhytidoplasty / Q000009:adverse effects / Q000379:methods*; D049291:Seroma / Q000209:etiology; D014014:Tissue Adhesives / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D015718:Fibrin Tissue Adhesive; D014014:Tissue Adhesives
keywords: Face-lift; Haematoma; Platelet-rich plasma; Rhytidectomy; Rhytidoplasty; Tissue sealant