Comparative Efficacy of Negative Pressure Wound Therapy and Conventional Treatments in the Management of Diabetic Foot Ulcers: A Systematic Review and Meta-Analysis

负压伤口治疗与常规治疗糖尿病足溃疡疗效比较:系统评价和荟萃分析

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Abstract

Background: Diabetic foot syndrome is a common complication of diabetes mellitus, and its incidence is increasing due to increasing rates of overweight and an aging population. Negative pressure wound therapy has been shown to improve wound healing. This study aimed to analyze the efficacy of this therapy compared with conventional treatments in patients with diabetic foot ulcers. Methods: A systematic search was conducted in the following databases: PubMed, SCOPUS, CINAHL, and the Cochrane Library, and the methodological quality was assessed using the Rob2 scale. This meta-analysis was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Results: A total of 11 clinical trials involving 1117 subjects. The primary outcome was efficacy, which was measured by the complete healing rate, wound size, time to granulation tissue formation, adverse effects, amputations, hospital stay, and cost. This study demonstrated that this therapy improves healing (OR= -10.39, 95% CI [-14.22, -6.57]) and reduces wound size (OR = -4.11, 95% CI [-7.83, -0.39]) while potentially lowering overall costs. Conclusions: Limitations include heterogeneity and different variables measured in studies. Additionally, there were differences among the trials due to the lack of blinding. Although no significant differences were found in amputations or infections, this therapy reduces pain and decreases the use of antibiotics and analgesics. Its use requires individual and expert assessment to maximize its benefits.

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