Angulo Alexandra Rodríguez, Caballero-Alvarado José, Sarmiento-Falen Joaquín, Zavaleta-Corvera Carlos
Alexandra Rodríguez Angulo, MD, School of Medicine, Antenor Orrego Private University, Trujillo, Peru.
José Caballero-Alvarado, MD, School of Medicine, Antenor Orrego Private University, Trujillo, Peru.
J Wound Ostomy Continence Nurs. 2025;52(3):227-238. doi: 10.1097/WON.0000000000001164. Epub 2025 May 16.
The purpose of this systematic and metanalysis was to compare wound healing-related outcomes of negative pressure wound therapy (NPWT) to conventional therapy outcomes (time to granulation tissue formulation, ulcer depth, adverse effects amputation, pain, infection, and bleeding, along with hospital length of stay) for treatment of diabetic foot ulcers (DFU) in adults.
Systematic review and meta-analysis of pooled data.
The electronic databases PubMed, Scopus, Web of Science, and Embase were searched. An artificial intelligence powered (Rayyan), proprietary software was used to retrieve, remove duplicates, and cite studies identified in our search. Two researchers and a conflict referee screened the studies in 2 phases; a title/abstract review, followed by reading all articles in full before identifying 12 studies included in this systematic review and metanalysis.
Twelve studies were included in our metanalysis; 8 were clinical trials and 4 were observational studies. The pooled sample in the 8 clinical trials comprised 760 participants; 373 were managed with NPWT and 387 were managed with conventional therapy. No significant difference was observed for ulcer depth (P = .16). However, significant differences were found in mean difference in time to granulation tissue formation (P = .03), rate of amputation, pain (P = .01), infection rates (P = .005), and hospital length of stay (P < .001). The pooled sample evaluated in the 4 observational studies was 222; 100 were managed with NPWT and 122 with CT. Significant differences were found in time to granulation tissue formation (P < .001), amputation rates (P = .04), infection rate (P = .04), and hospital length of stay (P < .001).
NPWT improves time to granulation tissue formation, reduces hospital stay, and the risk of secondary amputations, infections, and pain. Based on these findings we recommend incorporating NPWT as a standard component of DFU management.
本系统评价和荟萃分析旨在比较负压伤口治疗（NPWT）与传统治疗（肉芽组织形成时间、溃疡深度、不良反应、截肢、疼痛、感染和出血以及住院时间）在治疗成人糖尿病足溃疡（DFU）方面与伤口愈合相关的结局。
对汇总数据进行系统评价和荟萃分析。
检索电子数据库PubMed、Scopus、Web of Science和Embase。使用人工智能驱动的（Rayyan）专有软件检索、去除重复项并引用在我们的检索中识别出的研究。两名研究人员和一名冲突仲裁员分两个阶段筛选研究；首先进行标题/摘要审查，然后在确定本系统评价和荟萃分析纳入的12项研究之前通读所有文章全文。
我们的荟萃分析纳入了12项研究；8项为临床试验，4项为观察性研究。8项临床试验中的汇总样本包括760名参与者；373名接受NPWT治疗，387名接受传统治疗。溃疡深度未观察到显著差异（P = 0.16）。然而，在肉芽组织形成时间的平均差异（P = 0.03）、截肢率、疼痛（P = 0.01）、感染率（P = 0.005）和住院时间（P < 0.001）方面发现了显著差异。4项观察性研究中评估的汇总样本为222名；100名接受NPWT治疗，122名接受CT治疗。在肉芽组织形成时间（P < 0.001）、截肢率（P = 0.04）、感染率（P = 0.04）和住院时间（P < 0.001）方面发现了显著差异。
NPWT可改善肉芽组织形成时间，缩短住院时间，并降低二次截肢、感染和疼痛的风险。基于这些发现，我们建议将NPWT纳入DFU管理的标准组成部分。
