Flores-Escobar Sebastián, Álvaro-Afonso Francisco Javier, García-Álvarez Yolanda, López-Moral Mateo, Lázaro-Martínez José Luis, García-Morales Esther
Diabetic Foot Unit, Clínica Universitaria de Podología, Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, 28040 Madrid, Spain.
Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain.
J Clin Med. 2022 Mar 30;11(7):1911. doi: 10.3390/jcm11071911.
A systematic review and meta-analysis were carried out to investigate the effect of ultrasound-assisted wound (UAW) debridement in patients with diabetic foot ulcers (DFUs). All selected studies were evaluated using the Cochrane risk of bias tool to assess the risk of bias for randomized controlled trials. PubMed and Web of Science were searched in October 2021 to find randomized clinical trials (RCT) assessing the effect of UAW debridement on DFUs. RevMan v5.4. was used to analyze the data with the Mantel-Haenszel method for dichotomous outcomes. A total of 8 RCT met our inclusion criteria, with 263 participants. Concerning the healing rate comparing UAW versus the control group, a meta-analysis estimated the pooled OR at 2.22 (95% CI 0.96-5.11, = 0.06), favoring UAW debridement, with low heterogeneity (x = 7.47, df = 5, = 0.19, I = 33%). Time to healing was similar in both groups: UAW group (14.25 ± 10.10 weeks) versus the control group (13.38 ± 1.99 weeks, = 0.87). Wound area reduction was greater in the UAW debridement group (74.58% ± 19.21%) than in the control group (56.86% ± 25.09%), although no significant differences were observed between them ( 0.24). UAW debridement showed higher healing rates, a greater percentage of wound area reduction, and similar healing times when compared with placebo (sham device) and standard of care in patients with DFUs, although no statistically significant differences were observed between groups.
开展了一项系统评价和荟萃分析，以研究超声辅助伤口清创术（UAW）对糖尿病足溃疡（DFU）患者的疗效。使用Cochrane偏倚风险工具对所有入选研究进行评估，以评估随机对照试验的偏倚风险。于2021年10月检索了PubMed和科学网，以查找评估UAW清创术对DFU疗效的随机临床试验（RCT）。使用RevMan v5.4采用Mantel-Haenszel方法对二分法结果进行数据分析。共有8项RCT符合我们的纳入标准，涉及263名参与者。关于UAW与对照组的愈合率比较，荟萃分析估计合并比值比为2.22（95%可信区间0.96 - 5.11，P = 0.06），支持UAW清创术，异质性较低（χ² = 7.47，自由度 = 5，P = 0.19，I² = 33%）。两组的愈合时间相似：UAW组（14.25 ± 10.10周）与对照组（13.38 ± 1.99周，P = 0.87）。UAW清创术组的伤口面积减少幅度（74.58% ± 19.21%）大于对照组（56.86% ± 25.09%），尽管两组之间未观察到显著差异（P = 0.24）。与安慰剂（假装置）和DFU患者的标准护理相比，UAW清创术显示出更高的愈合率、更大的伤口面积减少百分比和相似的愈合时间，尽管两组之间未观察到统计学上的显著差异。
