A Meta-analysis On The Efficacy Of Negative Pressure Wound Therapy For Diabetic Foot Ulcers

Objective The purpose of this meta-analysis was to evaluate clinical efficacy and safety of negative pressure wound therapy(NPWT)compared with standard wound care(SWC)in the treatment of diabetic foot ulcers in patient with mellitus.Methods We searched Cochrane Library,Pubmed,Embase and CNKI databases for randomized controlled trials published up to December of 2019.All articles comparing negative pressure wound therapy with standard wound care for diabetic foot ulcers were included.Studies and data were selected and extracted independently by two reviewers.The data were analyzed with Revman5.3,a meta-analysis software made by Cochrane Library.Results A total of 18 randomized controlled trials,included 1483 patients,were finally preserved.Overall,significant differences were found between experimental and control group.Contrasted with standard wound care,NPWT had a higher healing rate(RR:1.48,95%CI:1.25~1.74,P < 0.00001),shorter healing time(MD:-13.5,95%CI:-32.81~5.81,P=0.17),more reduction of ulcer area(MD:6.57,95%CI:1.5~11.63,P=0.01),more reduction in ulcer depth(MD:24.86,95%CI:0.73~48.98,P=0.04),faster formation of granulation tissue(MD:-18.35,95%CI:-21.18~-15.53,P < 0.00001).NPWT also had fewer amputations(RR:0.33,95%CI:0.18~0.62,P=0.0004).No significant difference was found between NPWT and SWC on incidence of adverse effects(RR:1.12,95%CI:0.66~1.89,P=0.68).Conclusion Negative pressure wound therapy is a more efficacious treatment for diabetic foot ulcers,and virtually the same with standard wound care in terms of safety.