Peripheral Neuropathy after Open Abdominal Surgery with Self-Retaining Retractors. A Systematic Review of Randomised and Non-Randomised Clinical Trials

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DOI: 10.4236/ojog.2017.78081    1,105 Downloads   3,429 Views  Citations

ABSTRACT

Objectives : A systematic review was undertaken to evaluate the effectiveness of incision retention available to surgeons conducting open abdominal or pelvic surgeries. Both the ability of the retractor to retain the wound and harm to the patient due to the retractor were reviewed. Methods : A search was conducted using the following databases: EMBASE, PubMed, BIOSIS, Engineering Village, Web of Science, Best practice, Science Direct, CRCnet BASE, Proquest, Wiley Online Library, and Comprehensive Biomaterial. Results : What the articles found were then narrowed down to those which matched the objective of the review. This resulted in ten articles to review. Two reviewers reviewed and summarized the articles. Femoral neuropathy was found to be a common complication due to Retractors. Other outcomes analysed or studied were found to be infected, postoperative pain and exposure provided. Femoral neuropathy can be estimated to occur at a rate between 2.6% and 7.5% in open pelvic and abdominal surgeries. The Alexis O-ring retractor was found to lower the required morphine intake following surgery when compared to the Belfour retractor. Conclusions : There is a lack of high quality/high levels of evidence studies that have been conducted on Retractors. Femoral neuropathy is the outcome most commonly documented in relation to Retractors. Surgeons need to be aware about the use and implementations of the retractors. Care should be taken in protecting the blades and during long surgery relocating retractors should be considered.

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Chowdary, P. and Baumann, M. (2017) Peripheral Neuropathy after Open Abdominal Surgery with Self-Retaining Retractors. A Systematic Review of Randomised and Non-Randomised Clinical Trials. Open Journal of Obstetrics and Gynecology, 7, 800-814. doi: 10.4236/ojog.2017.78081.

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