Efficacy and safety of negative pressure wound therapy for the treatment of diabetic foot ulcers: A meta-analysis.

BACKGROUND

Diabetic foot ulcers (DFUs) are a significant challenge in diabetic care, and the efficacy of negative pressure wound therapy (NPWT) in treating them remains a subject of continuous investigation.

AIM

To provide a comprehensive meta-analysis of the role of NPWT in the management of DFUs.

METHODS

A systematic review was performed based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, searching databases like PubMed, Embase, Web of Science, and the Cochrane Library. Randomized clinical trials (RCTs) were included to compare NPWT to other dressings for DFUs. Outcomes measured were wound healing time and rate, granulation tissue formation time, amputation rate, and adverse events. Study quality was evaluated using Cochrane's risk of bias tool. Analyses utilized , , fixed or random-effects models Stata v17.

RESULTS

Of the 1101 identified articles, 9 RCTs were selected for meta-analysis. Studies spanned from 2005 to 2020 and originated from countries including the United States, Chile, Pakistan, Italy, India, and Germany. Meta-analysis demonstrated a significant improvement in wound healing rate [risk ratio (RR) = 1.46, 95%CI: 1.22-1.76, < 0.01] and a reduction in amputation rate (RR = 0.69, 95%CI: 0.50-0.96, = 0.006) with NPWT. Furthermore, the time for granulation tissue formation was significantly reduced by an average of 19.54 days. However, the incidence of adverse events did not significantly differ between NPWT and control treatments.

CONCLUSION

NPWT significantly improves wound healing rates and reduces amputation rates in DFUs. It also hastens the formation of granulation tissue. However, the therapy does not significantly alter the risk of adverse events compared to alternate treatments.