Mesenchymal Stem Cell Therapy For Diabetic Foot Ulcers:A Meta-analysis

Objective:To perform a meta-analysis to evaluate the efficacy of mesenchymal stem cell therapy in the management of diabetic foot ulcer.Methods:We systematically searched online databases including PubMed,Web of Science,Embase,Medline,Cochrane Library,OVID Database and CNKI,CBM etc,from inception to November 2018 for randomized controlled trials assessing the efficacy of mesenchymal stem cell therapy in diabetic foot ulcer.Results:Eight randomized controlled clinical trials were included.Meta-analysis showed that the mesenchymal stem cell therapy could(1)increase ulcer healing rate[ OR=2.50,95%CI(1.26,4.97),P=0.009,P<0.01],enhance ulcer size reduction[ WMD=-3.510,95%CI(-4.654,-2.366),P<0.01],hold prominent promise in the management of refractory diabetic foot ulcers;(2)improve ankle-brachial index[ WMD=0.11,95%CI(0.07,0.15),P<0.01],transcutaneous arterial oxygen tension [ SMD=1.82,95%CI(1.28,2.37),P<0.01]and blood flow;(3)significantly improved the amputation-free survival rate[OR=0.11,95%CI(0.02,0.61),P=0.011,P<0.05];(4)No patient in these trials had significant adverse effect.Conclusion:Mesenchymal stem cell therapy could accelerate the rate of diabetic foot ulcer healing,improve partial circulation and amputation-free survival rate,pose a promising comprehensive therapy strategy for the treatment of diabetic foot ulcers.