The quality of evidence is downgraded by study limitations (unclear allocation concealment and blinding), and by imprecise results (few patients and outcome events).
A Cochrane review [Abstract] 1 included 11 studies with a total of 972 subjects with diabetes. Two studies focused on postamputation wounds and all other studies included foot ulcers. Ten studies compared negative pressure wound therapy (NPWT) with dressings, and 1 study compared NPWT delivered at 75 mmHg with NPWT delivered at 125 mmHg.
NPWT compared with dressings for postoperative wounds:There was an increased number of healed wounds in the NPWT group compared with the dressings group, and a 21 days shorter median time to healing. No dignificant difference in amputation risk was observed (table T1).NPWT compared with dressings for foot ulcers: NPWT increased the number of healed wounds, reduced the risk of amputation (table T2), and reduced the time to healing compared with dressings (HR 1.82, 95% CI 1.27 to 2.60; 1 study, n=341).Low-pressure 75 mmHg compared with high-pressure 125 mmHg NPWT for foot ulcers: There was no clear difference in the number of wounds closed or covered with surgery (RR 0.83, 95% CI 0.47 to 1.47) or in adverse events (RR 1.50, 95% CI 0.28 to 8.04) between groups during 4 weeks follow-up time (1 study, n=40).
Outcome | Participants (studies) | Assumed risk (dressings) | Corresponding risk (NPWT) | Relative effect (95% CI) |
---|---|---|---|---|
Proportion of wounds healed (mean follow-up 16 weeks) | 162 (1) | 388 per 1000 | 559 per 1000(400 to 780) | RR 1.44 (1.03 to 2.01) |
Time to healing (mean follow-up 16 weeks) | 162 (1) | 388 per 1000 | 609 per 1000(448 to 770) | HR 1.91(1.21 to 2.99) |
Amputation (mean follow-up 16 weeks or unspecified) | 292 (2) | 60 per 1000 | 23 per 1000(8 to 61) | RR 0.38 (0.14 to 1.02) |
Outcome | Participants (studies) | Assumed risk (dressings) | Corresponding risk (NPWT) | Relative effect (95% CI) |
---|---|---|---|---|
Proportion of wounds healed | 486 (5) | 406 per 1000 | 540 per 1000(475 to 617) | RR 1.40 (1.14 to 1.72) |
Amputation | 441 (3) | 114 per 1000 | 38 per 1000(17 to 80) | RR 0.33 (0.15 to 0.70) |
Date of latest search: 2024-01-15
Primary/Secondary Keywords