A systematic review of concomitant interventions to prevent persistent perforations following the removal of long-term ventilation tubes

ObjectiveTo review the current evidence for the use of concomitant interventions to reduce the persistent perforation rate following the removal of long-term ventilation tubes.Type of reviewA systematic review of the literature and meta-analysis of randomised controlled trials on this topic.Search strategyMedline (1952–2008), EMBASE (1974–2008) and the Cochrane Central Register of Controlled Trials. A combination of search terms were used in a search strategy derived from guidance from the Cochrane collaboration.Evaluation methodA review of all trials by two authors with grading of the level of evidence.ResultsFifteen studies using a variety of interventions were identified.ConclusionA multi-centre randomised controlled trial is indicated to validate findings of previous studies and elucidate any optimum intervention to reduce the persistent perforation rate.