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Review
. 2024 Apr;21(4):e14886.
doi: 10.1111/iwj.14886.

The effect of negative pressure wound therapy on the outcome of diabetic foot ulcers: A meta-analysis

Ning Zhang  1 , Yibin Liu  1 , Weiqi Yan  1 , Fei Liu  1
Affiliations
Review

The effect of negative pressure wound therapy on the outcome of diabetic foot ulcers: A meta-analysis

Ning Zhang et al. Int Wound J. 2024 Apr.

Retraction in

Abstract

Negative pressure injury is one of the auxiliary methods of treating diabetes foot ulcers. It has been shown to be superior to conventional techniques in randomized controlled trials (RCTs). Nevertheless, the results of observational research are still scarce. A systematic review of RCTs and observations was carried out to evaluate the effectiveness and security of negative pressure wound therapy (NPWT) treatment for diabetes foot ulcers. Three English e-databases have been found for NPWT research. The meta-analyses of the comparative studies provided point estimates of results. Intermediate results were given as median and binary values were given in the form of odds ratios (OR). Seventeen trials, 13 RCTs and four randomized, controlled trials were found in the survey. Of these, 831 were treated with NPWT, 834 were treated with standard therapy. A total of 14 studies have been conducted to investigate the influence of NPWT on the healing of diabetic foot ulcers(DFU). In the study, NPWT was shown to speed up the healing of the wound in DFU patients(OR, 2.57; 95% CI, 1.72, 3.85 p < 0.0001). A subgroup analysis showed that NPWT was associated with an acceleration of the wound healing rate in 10 RCT trials (OR, 2.48; 95% CI, 1.58, 3.89 p < 0.001). In the four nRCT trials, NPWT was also shown to speed up the healing of the wound(OR, 2.95; 95% CI, 1.03, 8.42 p = 0.04). In 11 studies, the influence of NPWT on amputations of diabetes mellitus (DM) foot ulcers was investigated. The results showed that NPWT was associated with a reduction in amputations (OR, 0.53; 95% CI, 0.37, 0.74 p = 0.0002).In a subgroup of RCT trials, nine RCT trials showed a reduction in amputations(OR, 0.61; 95% CI, 0.43, 0.87 p = 0.007). In both nRCT trials, NPWT also showed a reduction in amputations (OR, 0.03; 95% CI, 0.00, 0.24 p = 0.001). Generally speaking, NPWT can help to heal the wound and lower the risk of amputations in people with diabetes. The subgroup analysis showed similar results for the RCT and non-RCT trials. NPWT can be used to treat diabetes foot ulcers caused by diabetes.

Keywords: amputation; diabetic foot ulcer; wound healing.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

FIGURE 1
FIGURE 1
Flow chart of the study.
FIGURE 2
FIGURE 2
Risk of bias diagram (RCT).
FIGURE 3
FIGURE 3
Summary of risk of bias (RCT).
FIGURE 4
FIGURE 4
Risk of bias diagram (n‐RCT).
FIGURE 5
FIGURE 5
Summary of risk of bias (n‐RCT).
FIGURE 6
FIGURE 6
Forest plot of the effect of NPWT on wound healing in patients with diabetic foot ulcers.
FIGURE 7
FIGURE 7
Forest plot of the effect of NPWT on wound healing in patients with diabetic foot ulcers in subgroup analysed RCT and nRCT studies.
FIGURE 8
FIGURE 8
Forest plot of effect of NPWT on amputation in patients with diabetic foot ulcers.
FIGURE 9
FIGURE 9
Funnel plot of the effect of NPWT on amputation in patients with diabetic foot ulcers.
FIGURE 10
FIGURE 10
Forest plot of the effect of NPWT on amputation in patients with diabetic foot ulcers in subgroup analysed RCT and nRCT studies.
See this image and copyright information in PMC

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