Zhang J, Hu ZC, Chen D, Guo D, Zhu JY, Tang B, et al.
Plastic and reconstructive surgery. Date of publication 2014 Jul 1;volume 134(1):141-51.
1. Plast Reconstr Surg. 2014 Jul;134(1):141-51. doi: 10.1097/PRS.0000000000000275.
Effectiveness and safety of negative-pressure wound therapy for diabetic foot
ulcers: a meta-analysis.
Zhang J(1), Hu ZC, Chen D, Guo D, Zhu JY, Tang B.
Author information:
(1)Guangzhou, People's Republic of China From the Departments of Burns and
Plastic Surgery and Hepatobiliary Surgery, The First Affiliated Hospital of Sun
Yat-sen University; and the Department of Plastic Surgery, The Third Affiliated
Hospital of Sun Yat-sen University.
BACKGROUND: The authors conducted a meta-analysis to evaluate the effectiveness
and safety of negative-pressure wound therapy for diabetic foot ulcers.
METHODS: PubMed, EMBASE, and the Cochrane Library were searched to identify
relevant studies published up to February of 2013. All randomized controlled
trials comparing negative-pressure wound therapy and non-negative-pressure wound
therapy (i.e., standard wound care) for diabetic foot ulcers were included.
Results were pooled using meta-analysis to assess the efficacy and safety of
negative pressure in managing diabetic foot ulcers.
RESULTS: The databases were derived from eight qualified studies that included a
total of 669 patients. Overall, compared with the non-negative-pressure wound
therapy-treated diabetic foot ulcers, negative pressure resulted in a
significantly higher proportion of healed ulcers (relative risk, 1.52; 95 percent
CI, 1.23 to 1.89; p<0.001), more reduction of ulcer area (standardized mean
difference, 0.89; 95 percent CI, 0.41 to 1.37; p=0.003), and shorter time to
wound healing (standardized mean difference, -1.10; 95 percent CI, -1.83 to
-0.37; p=0.003). Negative-pressure wound therapy patients also experienced
significantly fewer major amputations (relative risk, 0.14; 95 percent CI, 0.04
to 0.51; p=0.003), but the rate of minor amputations was not affected (p=0.837).
No significant difference was observed between negative-pressure wound therapy
and non-negative-pressure wound therapy (p=0.683). No heterogeneity among studies
was detected.
CONCLUSION: Negative-pressure wound therapy appears to be more effective for
diabetic foot ulcers compared with non-negative-pressure wound therapy, and has a
similar safety profile.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, II.
DOI: 10.1097/PRS.0000000000000275
PMID: 24622569 [Indexed for MEDLINE]
