Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen (IQWiG), Köln.
Dtsch Arztebl Int. 2011 Jun;108(22):381-9. doi: 10.3238/arztebl.2011.0381. Epub 2011 Jun 3.
In negative-pressure wound therapy (NPWT), a wound is covered with an airtight dressing, and negative pressure is applied. This is thought to promote healing. We evaluated NPWT with an updated, systematic review of the literature.
We systematically searched the PubMed and Cochrane Library databases for randomized, controlled trials (RCTs) of NPWT for the treatment of acute or chronic wounds. The primary outcome was complete wound closure.
We found reports of 9 RCTs in addition to the 12 covered by earlier IQWiG reviews of this topic. Five of the 9 new trials involved NPWT systems that are not on the market. The frequency of complete wound closure is stated in only 5 of the 9 new reports; a statistically significant effect in favor of NPWT was found in only two trials.The results of 8 of the 9 new trials are hard to interpret, both because of apparent bias and because diverse types of wounds were treated.
Although there may be a positive effect of NPWT, we did not find clear evidence that wounds heal any better or worse with NPWT than with conventional treatment. Good RCTs are still needed to evaluate NPWT.
在负压伤口治疗（NPWT）中，用密封敷料覆盖伤口，并施加负压。这被认为可以促进愈合。我们对文献进行了更新的系统评价，评估了 NPWT。
我们系统地检索了 PubMed 和 Cochrane Library 数据库，以寻找 NPWT 治疗急性或慢性伤口的随机对照试验（RCT）。主要结局是完全伤口闭合。
除了之前 IQWiG 对该主题的 12 项综述涵盖的内容外，我们还发现了 9 项 RCT 的报告。其中 5 项新试验涉及市场上没有的 NPWT 系统。仅在 9 份新报告中的 5 份中报告了完全伤口闭合的频率；只有两项试验发现 NPWT 有统计学上的显著效果。由于明显的偏倚和治疗的伤口类型多种多样，这 9 项新试验中的 8 项结果难以解释。
尽管 NPWT 可能有积极的效果，但我们没有发现明确的证据表明 NPWT 比常规治疗能使伤口更快或更慢地愈合。仍需要良好的 RCT 来评估 NPWT。
