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已发表论文
对糖尿病足溃疡患者进行负压伤口治疗的评价：一个系统评价和综合分析
Authors Liu S, He C, Cai Y, Xing Q, Guo Y, Chen Z, Su J, Yang L
Received 28 December 2016
Accepted for publication 7 March 2017
Published 18 April 2017 Volume 2017:13 Pages 533—544
DOI https://doi.org/10.2147/TCRM.S131193
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Hoa Le
Peer reviewer comments 2
Editor who approved publication: Professor Deyun Wang
Objectives: The aim of this study
was to perform an updated systematic review and meta-analysis to assess the
clinical efficacy, safety, and cost-effectiveness of negative-pressure wound
therapy (NPWT) in the treatment of diabetic foot ulcers (DFUs).
Methods: We searched the Cochrane Library, MEDLINE, EMBASE, Ovid, and Chinese Biological Medicine databases up to June 30, 2016. We also manually searched the articles from reference lists of the retrieved articles, which used the NPWT system in studies of vacuum-assisted closure therapy. Studies were identified and selected, and two independent reviewers extracted data from the studies.
Results: A total of eleven randomized controlled trials, which included a total of 1,044 patients, were selected from 691 identified studies. Compared with standard dressing changes, NPWT had a higher rate of complete healing of ulcers (relative risk, 1.48; 95% confidence interval [CI]: 1.24–1.76; P <0.001), shorter healing time (mean difference, −8.07; 95% CI: −13.70–−2.45; P =0.005), greater reduction in ulcer area (mean difference, 12.18; 95% CI: 8.50–15.86; P <0.00001), greater reduction in ulcer depth (mean difference, 40.82; 95% CI: 35.97–45.67; P <0.00001), fewer amputations (relative risk, 0.31; 95% CI: 0.15–0.62; P =0.001), and no effect on the incidence of treatment-related adverse effects (relative risk, 1.12; 95% CI: 0.66–1.89; P =0.68). Meanwhile, many analyses showed that the NPWT was more cost-effective than standard dressing changes.
Conclusion: These results indicate that NPWT is efficacious, safe, and cost-effective in treating DFUs.
Keywords: diabetic foot ulcers, negative-pressure wound therapy, complete wound closure, amputation, meta-analysis, cost-effectiveness
Methods: We searched the Cochrane Library, MEDLINE, EMBASE, Ovid, and Chinese Biological Medicine databases up to June 30, 2016. We also manually searched the articles from reference lists of the retrieved articles, which used the NPWT system in studies of vacuum-assisted closure therapy. Studies were identified and selected, and two independent reviewers extracted data from the studies.
Results: A total of eleven randomized controlled trials, which included a total of 1,044 patients, were selected from 691 identified studies. Compared with standard dressing changes, NPWT had a higher rate of complete healing of ulcers (relative risk, 1.48; 95% confidence interval [CI]: 1.24–1.76; P <0.001), shorter healing time (mean difference, −8.07; 95% CI: −13.70–−2.45; P =0.005), greater reduction in ulcer area (mean difference, 12.18; 95% CI: 8.50–15.86; P <0.00001), greater reduction in ulcer depth (mean difference, 40.82; 95% CI: 35.97–45.67; P <0.00001), fewer amputations (relative risk, 0.31; 95% CI: 0.15–0.62; P =0.001), and no effect on the incidence of treatment-related adverse effects (relative risk, 1.12; 95% CI: 0.66–1.89; P =0.68). Meanwhile, many analyses showed that the NPWT was more cost-effective than standard dressing changes.
Conclusion: These results indicate that NPWT is efficacious, safe, and cost-effective in treating DFUs.
Keywords: diabetic foot ulcers, negative-pressure wound therapy, complete wound closure, amputation, meta-analysis, cost-effectiveness
