期刊
PLASTIC AND RECONSTRUCTIVE SURGERY
卷 134, 期 1, 页码 141-151出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/PRS.0000000000000275
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资金
- National Natural Science Foundation of China [30973128, 81272096]
- Research Fund for the Doctoral Program of Higher Education of China [20110171110064]
- Sun Yat-sen University Clinical Research 5010 Program [2013001]
Background: The authors conducted a meta-analysis to evaluate the effectiveness and safety of negative-pressure wound therapy for diabetic foot ulcers. Methods: PubMed, EMBASE, and the Cochrane Library were searched to identify relevant studies published up to February of 2013. All randomized controlled trials comparing negative-pressure wound therapy and non-negative-pressure wound therapy (i.e., standard wound care) for diabetic foot ulcers were included. Results were pooled using meta-analysis to assess the efficacy and safety of negative pressure in managing diabetic foot ulcers. Results: The databases were derived from eight qualified studies that included a total of 669 patients. Overall, compared with the non-negative-pressure wound therapy-treated diabetic foot ulcers, negative pressure resulted in a significantly higher proportion of healed ulcers (relative risk, 1.52; 95 percent CI, 1.23 to 1.89; p < 0.001), more reduction of ulcer area (standardized mean difference, 0.89; 95 percent CI, 0.41 to 1.37; p = 0.003), and shorter time to wound healing (standardized mean difference, -1.10; 95 percent CI, -1.83 to -0.37; p = 0.003). Negative-pressure wound therapy patients also experienced significantly fewer major amputations (relative risk, 0.14; 95 percent CI, 0.04 to 0.51; p = 0.003), but the rate of minor amputations was not affected (p = 0.837). No significant difference was observed between negative-pressure wound therapy and non-negative-pressure wound therapy (p = 0.683). No heterogeneity among studies was detected. Conclusion: Negative-pressure wound therapy appears to be more effective for diabetic foot ulcers compared with non-negative-pressure wound therapy, and has a similar safety profile.
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