Willy Christian, Voelker Hans-Ulrich, Engelhardt Michael
Department of Surgery, Military Hospital Ulm, Ulm, Germany.
Department of Surgery, Military Hospital Ulm, Oberer Eselsberg 40, 89081, Ulm, Germany.
Eur J Trauma Emerg Surg. 2007 Feb;33(1):33-9. doi: 10.1007/s00068-007-6143-4. Epub 2007 Feb 24.
Today, vacuum therapy can be regarded as established in routine clinical use. Many hundreds of reports on the subject of vacuum therapy have appeared in medical literature. This review intends to give an overview of the peer-reviewed literature published to date and its quality considering criteria of evidence-based medicine (EbM).
Literature search (MEDLINE, EMBASE, Cochrane, extensive manual search); up to May 31, 2006; evidence level: Classification of the Oxford Centre for Evidence-based Medicine.
Five hundred and fifty peer-reviewed citations were identified. Impressive jump in the annual publication rate is found from the year 2000 onwards; continuous broadening of the fields of indications; over 85% of all reports are case reports/series (only n = 27; EbM level < 4). To date, most of the publications are by authors from the United States, Germany, United Kingdom, Austria, the Netherlands, Switzerland, France, and Sweden. 7.5% of all peer-reviewed articles investigate scientific back grounds.
The clinical significance of this therapy is underlined by an obviously continuously marked extension of the range of indications in all surgical fields, and even in extreme ages of the patients. There is a considerable deficit of basic pathophysiological research and well-designed studies. This "deficiency," however, when judged against the quality of the general medical literature, does not point to the poor efficacy or low benefit of vacuum therapy but should rather be seen as a symptom of the clinical practitioner's problems in dealing with modern aspects of the theoretical background of EbM.
如今，负压疗法可被视为已确立的常规临床应用方法。医学文献中已出现了数百篇关于负压疗法的报告。本综述旨在概述迄今为止已发表的经同行评审的文献及其依据循证医学（EbM）标准的质量。
文献检索（MEDLINE、EMBASE、Cochrane、广泛的手工检索）；截至2006年5月31日；证据水平：牛津循证医学中心的分类。
共识别出550篇经同行评审的文献引用。从2000年起，年发表率有显著跃升；适应证领域不断拓宽；所有报告中超过85%为病例报告/系列（仅n = 27；EbM水平<4）。迄今为止，大多数出版物的作者来自美国、德国、英国、奥地利、荷兰、瑞士、法国和瑞典。所有经同行评审的文章中有7.5%研究了科学背景。
在所有外科领域，甚至在患者的极端年龄阶段，该疗法适应证范围明显持续显著扩大，突显了其临床意义。基础病理生理学研究和设计良好的研究存在相当大的不足。然而，与普通医学文献的质量相比，这种“不足”并非表明负压疗法疗效不佳或益处低，而应被视为临床医生在应对循证医学理论背景的现代方面存在问题的一种表现。
