The efficacy of early elastic bandage in the treatment of subdural effusion after decompressive craniectomy: a meta-analysis.

Abstract

<h4>Background</h4>We aimed to investigate the safety and efficacy of early elastic bandage in treating subdural effusion after decompressive craniectomy.<h4>Methods</h4>We searched Cochrane Library, Web of Science, Embase, PubMed, CNKI, VIP, and Wanfang databases for randomized controlled trials assessing the effects of early use of elastic bandages on subdural effusion. Studies published from the establishment of the database to March 2024 were retrieved. A risk of bias assessment tool, Cochrane was independently used by two researchers to assess the quality of the included studies. The analysis was conducted using RevMan 5.4 software. Heterogeneity was determined using I² test and P-value. Publication bias was evaluated based on the funnel plot.<h4>Results</h4>Ten studies with 954 patients were included. The results of the meta-analysis showed that the risk of subdural effusion elastic bandage group was lower than the conventional treatment group (HR = 0.46, 95% CI: 0.23-0.92, P = 0.03). In addition, risk of adverse events in the experimental group was lower than that in the control group (HR = 0.46, 95% CI: 0.23-0.92, P = 0.03), and there was no significant difference in GOS ≥ 3 between the experimental group and the control group after treatment (HR = 1.12, 95% CI: 0.89-1.42, P = 0.34). Moreover, the number of patients with hospitalization length ≤ 30 days in the experimental group was better than that in the control group (HR = 1.90, 95% CI: 1.31-2.77, P = 0.0007).<h4>Conclusions</h4>This analysis suggests early elastic bandaging is a promising, low-cost intervention for preventing subdural effusion and reducing hospitalization after decompressive craniectomy, though not for improving neurological function. It's definitive role in clinical practice should be established by future multinational trials that address the current limitations in evidence quality.<h4>Trial registration</h4>CRD42024551332 (06/06/2024).