Cangzhou Central Hospital, Cangzhou City, China.
Medicine (Baltimore). 2022 Aug 5;101(31):e29537. doi: 10.1097/MD.0000000000029537.
This study conducted a meta-analysis to compare the effectiveness and safety of the negative pressure wound therapy (NPWT) with the moist wound care (MWC) in the treatment of diabetic foot ulcers (DFUs).
The PubMed, EMBASE, and CENTRAL were searched by 2 of the authors, to identify randomized controlled trials comparing the clinical outcomes of patients treated with NPWT versus MWC for DFUs. Meta-analyses were performed for several outcomes, including wound healing results, amputation or resection incidence, and risk of adverse events, utilizing the "meta" package of R language version 4.0.3.
A total of 10 trials (619 patients in NPWT group and 625 in MWC group) and 8 trials were included for the qualitative and quantitative syntheses, respectively. As a result, significantly lower risk of non-closure of the wound (risk ratio [RR] = 0.74, 95% confidence interval [CI]: 0.63-0.87; P = .001), lower average wound area (standard mean difference = -0.80, 95% CI: -1.54 to -0.06; P = .034), more wound area decrease (standard mean difference = 0.81, 95% CI: 0.36-1.26; P = .001), increased appearance rate of granulation tissue (RR = 1.61, 95% CI: 1.07-2.41; P-0.021), and lower risk of amputation or resection (RR = 0.70, 95% CI: 0.50-0.99; P = .045), were demonstrated for the NPWT group when compared to MWC group. However, no statistically significant difference was found for the disappearance rate of wound discharge at 8 weeks, the rate of blood culture positivity, VAS-pain score, and the overall frequency of adverse events between the 2 treatment groups (P = .05).
NPWT could accelerate process of the wound healing, and decrease the risk of post-treatment amputation or resection, without any additional frequency of adverse events, when compared with MWC, in patients with DFUs.
本研究进行了荟萃分析，比较了负压伤口治疗（NPWT）与湿性伤口护理（MWC）治疗糖尿病足溃疡（DFUs）的疗效和安全性。
由两名作者检索 PubMed、EMBASE 和 CENTRAL，以确定比较 NPWT 与 MWC 治疗 DFUs 患者临床结局的随机对照试验。使用 R 语言版本 4.0.3 的“meta”包对包括伤口愈合结果、截肢或切除发生率和不良事件风险在内的几个结局进行了荟萃分析。
共有 10 项试验（NPWT 组 619 例，MWC 组 625 例）纳入定性和定量综合分析。结果表明，NPWT 组的伤口未闭合风险显著降低（风险比 [RR] = 0.74，95%置信区间 [CI]：0.63-0.87；P =.001），平均伤口面积更小（标准均数差 = -0.80，95%CI：-1.54 至 -0.06；P =.034），伤口面积减少更多（标准均数差 = 0.81，95%CI：0.36-1.26；P =.001），肉芽组织出现率更高（RR = 1.61，95%CI：1.07-2.41；P =.021），截肢或切除风险更低（RR = 0.70，95%CI：0.50-0.99；P =.045）。然而，两组在 8 周时伤口分泌物消失率、血培养阳性率、VAS 疼痛评分和不良事件总发生率方面无统计学差异（P =.05）。
与 MWC 相比，NPWT 可加速 DFUs 患者的伤口愈合过程，降低治疗后截肢或切除的风险，且不会增加不良事件的发生频率。
