Revisiting the Role of Pressure Dressing After Otologic Surgery: A Systematic Review and Meta-Analysis.

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.