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Wound complications following surgery to the lymph nodes: A protocol for a systematic review and meta-analysis

Nzenwa, Ikemsinachi C.; Iqbal, Hassan A.; Hardie, Claire; Smith, George E.; Matteucci, Paolo L.; Totty, Joshua P.


Ikemsinachi C. Nzenwa

Hassan A. Iqbal

Claire Hardie

George E. Smith

Paolo L. Matteucci

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Mr Josh Totty
NIHR Clinical Lecturer in Plastic Surgery



Malignancies that spread to the lymph nodes may be identified through surgical biopsy, and treatment of metastatic disease may be through lymph node dissection. These surgeries, however, may be associated with significant adverse outcomes, particularly wound complications, the true incidence of which remains unknown. Multiple studies have reported their individual rates of complications in isolation. The aim of this study will be to systematically evaluate data that presents the incidence of wound complications in patients undergoing these surgeries.


We have designed and registered a protocol for a systematic review and meta-analysis of studies presenting incidence data. We will search MEDLINE, EMBASE and CENTRAL for relevant articles. Meta-analysis will be undertaken to synthesise an overall incidence of surgical site infection, wound dehiscence, haematoma and seroma. Subgroup analyses will investigate the effects of anatomical location, primary malignancy and study design on pooled incidence. Risk of bias will be evaluated for each included study using bespoke tools matched to the study design.


The results of this study will provide the incidence of wound complications and secondary complications following lymph node surgery. This will directly impact upon the consent process, and may influence the nature of future research studies aimed at reducing post-operative complications.


Nzenwa, I. C., Iqbal, H. A., Hardie, C., Smith, G. E., Matteucci, P. L., & Totty, J. P. (2022). Wound complications following surgery to the lymph nodes: A protocol for a systematic review and meta-analysis. PLoS ONE, 17(8), Article e0272490.

Journal Article Type Article
Acceptance Date Jul 12, 2022
Online Publication Date Aug 3, 2022
Publication Date Aug 3, 2022
Deposit Date Aug 4, 2022
Publicly Available Date Aug 4, 2022
Journal PLOS ONE
Print ISSN 1932-6203
Publisher Public Library of Science
Peer Reviewed Peer Reviewed
Volume 17
Issue 8
Article Number e0272490
Keywords Multidisciplinary
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Copyright Statement
Copyright: © 2022 Nzenwa et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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