Huang Qiang, Wang Ji-Ting, Gu Han-Cheng, Cao Gang, Cao Jian-Chun
Surgeon, Department of the Fourth Surgery, Dong-Fang Hospital of Beijing University of Chinese Medicine, Beijing, China.
Surgeon, Department of the Fourth Surgery, Dong-Fang Hospital of Beijing University of Chinese Medicine, Beijing, China.
J Foot Ankle Surg. 2019 Sep;58(5):954-958. doi: 10.1053/j.jfas.2018.12.020.
Vacuum sealing drainage (VSD) is a noninvasive adjunctive therapy to help patients with diabetic foot ulcers by reducing edema and promoting wound healing and formation of granulation tissue. Multiple databases were searched for relevant studies, and full-text articles comparing VSD and conventional therapy were reviewed. Meta-analyses were conducted with Review Manager 5.0 software to estimate the results of the selected articles. Forest plots, sensitivity analysis, and bias analysis were also performed on the included articles. In total, 10 studies satisfied the inclusion criteria and were selected in this study. The meta-analysis suggested that the duration of therapy, decrease of wound size, and efficacy rate showed statistically significant differences between the 2 groups (mean difference = -12.86; 95% confidence interval [CI] -12.86 to -8.52; p < .00001; mean difference = 8.71; 95% CI 3.25 to 14.17; p = .002; relative risk = 1.41; 95% CI 1.22 to 1.62; p < .00001, respectively) although the complication rate between the 2 groups was comparable (relative risk = 0.83; 95% CI 0.60 to 1.16; p = .28). Publication bias was not assessed because only a few articles were included. In conclusion, VSD is a more effective therapy and is associated with a greater decrease in wound size and shorter time to wound healing, compared to the conventional method.
负压封闭引流(VSD)是一种非侵入性辅助治疗方法,通过减轻水肿、促进伤口愈合和肉芽组织形成来帮助糖尿病足溃疡患者。检索了多个数据库以查找相关研究,并对比较VSD和传统治疗的全文文章进行了综述。使用Review Manager 5.0软件进行荟萃分析以评估所选文章的结果。还对纳入的文章进行了森林图、敏感性分析和偏倚分析。本研究共纳入10项符合纳入标准的研究。荟萃分析表明,两组在治疗持续时间、伤口大小减小和有效率方面存在统计学显著差异(平均差=-12.86;95%置信区间[CI]-12.86至-8.52;p<.00001;平均差=8.71;95%CI 3.25至14.17;p=.002;相对风险=1.41;95%CI 1.22至1.62;p<.00001),尽管两组之间的并发症发生率相当(相对风险=0.83;95%CI 0.60至1.16;p=.28)。由于仅纳入了少数文章,因此未评估发表偏倚。总之,与传统方法相比,VSD是一种更有效的治疗方法,与伤口大小的更大减小和伤口愈合时间的缩短相关。