Cavan & Monaghan Primary Care Services, HSE CHO 1, Ireland.
Skin Wounds and Trauma Research Centre, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland.
J Wound Care. 2021 Oct 2;30(10):823-829. doi: 10.12968/jowc.2021.30.10.823.
The aim of this systematic review was to determine the impact of topical oxygen therapy (TOT) on diabetic foot ulcer (DFU) healing.
Using systematic review methodology, we considered randomised controlled trials (RCTs), controlled trials, pilot studies and observational studies. The search was conducted in January 2019, using PubMed, CINAHL, Ovid, Cochrane, Web of Science and EMBASE databases. Data analysis was undertaken using RevMan and a narrative synthesis. The article titles were assessed by two authors independently, and the abstracts (when available) of the studies identified by the search strategy were screened for their eligibility, according to the inclusion and exclusion criteria. The full-text version of potentially relevant studies was obtained and two authors independently screened this against the inclusion criteria. Data were extracted using a predesigned extraction tool and all included studies were quality appraised using the Evidence-Based Librarianship checklist.
The search returned 565 records of which eight met the inclusion criteria. Of the included studies, three were set in single centre outpatient wound clinics, two studies were set in an outpatient wound care research clinic and three studies were multisite. Meta-analysis of four studies was undertaken. DFUs are >2 times more likely to heal with TOT than with standard care alone. The odds ratio (OR)=2.49 (95% confidence interval (CI): 1.59-3.90, p=0.00001). The remaining four studies also showed that using TOT increased healing rates. An included study reported that time to 50% DFU closure was significantly shorter in participants who received the TOT, mean 18.4 days versus 28.9 days in the sham therapy group (p=0.001). However, the validity of 65.5% of the eight studies was assessed as low.
The findings suggest that TOT enhances healing for patients with hard-to-heal DFUs when used with standard care. The results from the trials reviewed also indicate a benefit for patients over standard care alone. However, the sample sizes in the studies were generally small, thus, more RCTs are warranted to further validate these findings.
The authors have no conflicts of interest to declare.
本系统评价旨在确定局部氧疗（TOT）对糖尿病足溃疡（DFU）愈合的影响。
使用系统评价方法，我们考虑了随机对照试验（RCT）、对照试验、试点研究和观察性研究。搜索于 2019 年 1 月在 PubMed、CINAHL、Ovid、Cochrane、Web of Science 和 EMBASE 数据库中进行。使用 RevMan 进行数据分析，并进行叙述性综合。两位作者独立评估文章标题，根据纳入和排除标准筛选搜索策略确定的研究的摘要（如有）以确定其是否符合条件。获得潜在相关研究的全文版本，两位作者独立根据纳入标准筛选该版本。使用预设的提取工具提取数据，所有纳入的研究均使用循证图书馆学清单进行质量评估。
搜索返回了 565 条记录，其中 8 条符合纳入标准。纳入的研究中，3 项研究在单一中心门诊伤口诊所进行，2 项研究在门诊伤口护理研究诊所进行，3 项研究在多地点进行。对 4 项研究进行了荟萃分析。与单独接受标准护理相比，DFU 用 TOT 治疗更有可能愈合。优势比（OR）=2.49（95%置信区间（CI）：1.59-3.90，p=0.00001）。其余四项研究也表明，使用 TOT 可提高愈合率。一项纳入的研究报告称，接受 TOT 的参与者达到 50%DFU 闭合的时间明显短于接受假治疗组，平均 18.4 天对 28.9 天（p=0.001）。然而，8 项研究中有 65.5%的有效性被评估为低。
研究结果表明，当与标准护理联合使用时，TOT 可促进难以愈合的 DFU 患者的愈合。综述中的试验结果也表明，患者使用 TOT 比单独接受标准护理更有获益。然而，研究的样本量通常较小，因此，需要更多的 RCT 来进一步验证这些发现。
作者无利益冲突。
