College of Medicine, Taipei Medical University, Taipei, Taiwan.
Division of Plastic Surgery, Department of Surgery, Taipei Municipal Wanfang Hospital, Taipei Medical University, Taipei, Taiwan.
Int Wound J. 2021 Feb;18(1):112-123. doi: 10.1111/iwj.13500. Epub 2020 Nov 25.
Negative pressure wound therapy (NPWT), which has been applied in various medical specialties to accelerate wound healing, has been the object of a few investigations. We explored the effectiveness of NPWT and the possibility of its inclusion in burn management guidelines. Randomised controlled trials comparing NPWT with non-NPWT treatments for burn wounds were extracted from PubMed. For the risk of bias analysis, all included studies were evaluated according to the Cochrane risk of bias tool and the approaches outlined in the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) Handbook. Outcomes such as graft take rate in the first week, infection rate, and overall complication rate were analysed. Six studies that included a total of 701 patients met our inclusion criteria. Qualitative analysis revealed that the NPWT group had a significantly better overall graft rate in the first week (P = 0.001) and a significantly lower infection rate (P = 0.04). No significant difference in the overall complication rate was found. Our results indicate that NPWT is a safe method for stimulating healing and lowering the infection rate of burn wounds. NPWT can be part of general burn management, and its incorporation into burn treatment guidelines is recommended.
负压伤口治疗(NPWT)已在多个医学专业领域应用,以加速伤口愈合,有少数研究对此进行了探讨。我们旨在探究 NPWT 的有效性及其纳入烧伤治疗指南的可能性。我们从 PubMed 中提取了比较 NPWT 与非 NPWT 治疗烧伤创面的随机对照试验。为了进行偏倚风险分析,我们根据 Cochrane 偏倚风险工具和 GRADE(推荐分级、评估、制定与评价)手册中概述的方法对所有纳入研究进行评估。分析了首次治疗后一周内的移植物成活率、感染率和总体并发症发生率等结局。符合纳入标准的研究共有 6 项,共纳入 701 例患者。定性分析表明,NPWT 组在首次治疗后一周内的总体移植物成活率显著更高(P=0.001),感染率显著更低(P=0.04)。两组总体并发症发生率无显著差异。我们的结果表明,NPWT 是一种安全的治疗方法,可促进愈合并降低烧伤创面的感染率。NPWT 可作为一般烧伤处理的一部分,建议将其纳入烧伤治疗指南。