{"title":"负压伤口治疗糖尿病足溃疡的疗效和安全性：一项荟萃分析。","authors":"Yun-Xiang Deng, Xiao-Chuan Wang, Zhen-Yu Xia, Meng-Ya Wan, Du-Yin Jiang","doi":"10.4239/wjd.v16.i6.103520","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Diabetic foot ulcers (DFUs) are a significant challenge in diabetic care, and the efficacy of negative pressure wound therapy (NPWT) in treating them remains a subject of continuous investigation.</p><p><strong>Aim: </strong>To provide a comprehensive meta-analysis of the role of NPWT in the management of DFUs.</p><p><strong>Methods: </strong>A systematic review was performed based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, searching databases like PubMed, Embase, Web of Science, and the Cochrane Library. Randomized clinical trials (RCTs) were included to compare NPWT to other dressings for DFUs. Outcomes measured were wound healing time and rate, granulation tissue formation time, amputation rate, and adverse events. Study quality was evaluated using Cochrane's risk of bias tool. Analyses utilized <i>χ</i> <sup>2</sup>, <i>I</i> <sup>2</sup>, fixed or random-effects models <i>via</i> Stata v17.</p><p><strong>Results: </strong>Of the 1101 identified articles, 9 RCTs were selected for meta-analysis. Studies spanned from 2005 to 2020 and originated from countries including the United States, Chile, Pakistan, Italy, India, and Germany. Meta-analysis demonstrated a significant improvement in wound healing rate [risk ratio (RR) = 1.46, 95%CI: 1.22-1.76, <i>P</i> < 0.01] and a reduction in amputation rate (RR = 0.69, 95%CI: 0.50-0.96, <i>P</i> = 0.006) with NPWT. Furthermore, the time for granulation tissue formation was significantly reduced by an average of 19.54 days. However, the incidence of adverse events did not significantly differ between NPWT and control treatments.</p><p><strong>Conclusion: </strong>NPWT significantly improves wound healing rates and reduces amputation rates in DFUs. It also hastens the formation of granulation tissue. However, the therapy does not significantly alter the risk of adverse events compared to alternate treatments.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"16 6","pages":"103520"},"PeriodicalIF":4.6000,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12179873/pdf/","citationCount":"0","resultStr":"{\"title\":\"Efficacy and safety of negative pressure wound therapy for the treatment of diabetic foot ulcers: A meta-analysis.\",\"authors\":\"Yun-Xiang Deng, Xiao-Chuan Wang, Zhen-Yu Xia, Meng-Ya Wan, Du-Yin Jiang\",\"doi\":\"10.4239/wjd.v16.i6.103520\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Diabetic foot ulcers (DFUs) are a significant challenge in diabetic care, and the efficacy of negative pressure wound therapy (NPWT) in treating them remains a subject of continuous investigation.</p><p><strong>Aim: </strong>To provide a comprehensive meta-analysis of the role of NPWT in the management of DFUs.</p><p><strong>Methods: </strong>A systematic review was performed based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, searching databases like PubMed, Embase, Web of Science, and the Cochrane Library. Randomized clinical trials (RCTs) were included to compare NPWT to other dressings for DFUs. Outcomes measured were wound healing time and rate, granulation tissue formation time, amputation rate, and adverse events. Study quality was evaluated using Cochrane's risk of bias tool. Analyses utilized <i>χ</i> <sup>2</sup>, <i>I</i> <sup>2</sup>, fixed or random-effects models <i>via</i> Stata v17.</p><p><strong>Results: </strong>Of the 1101 identified articles, 9 RCTs were selected for meta-analysis. Studies spanned from 2005 to 2020 and originated from countries including the United States, Chile, Pakistan, Italy, India, and Germany. Meta-analysis demonstrated a significant improvement in wound healing rate [risk ratio (RR) = 1.46, 95%CI: 1.22-1.76, <i>P</i> < 0.01] and a reduction in amputation rate (RR = 0.69, 95%CI: 0.50-0.96, <i>P</i> = 0.006) with NPWT. Furthermore, the time for granulation tissue formation was significantly reduced by an average of 19.54 days. However, the incidence of adverse events did not significantly differ between NPWT and control treatments.</p><p><strong>Conclusion: </strong>NPWT significantly improves wound healing rates and reduces amputation rates in DFUs. It also hastens the formation of granulation tissue. However, the therapy does not significantly alter the risk of adverse events compared to alternate treatments.</p>\",\"PeriodicalId\":48607,\"journal\":{\"name\":\"World Journal of Diabetes\",\"volume\":\"16 6\",\"pages\":\"103520\"},\"PeriodicalIF\":4.6000,\"publicationDate\":\"2025-06-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12179873/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"World Journal of Diabetes\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.4239/wjd.v16.i6.103520\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ENDOCRINOLOGY & METABOLISM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"World Journal of Diabetes","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.4239/wjd.v16.i6.103520","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
引用次数: 0
摘要
背景：糖尿病足溃疡（DFUs）是糖尿病护理中的一个重大挑战，负压伤口治疗（NPWT）治疗糖尿病足溃疡的疗效仍然是一个持续研究的主题。目的：对NPWT在dfu治疗中的作用进行综合荟萃分析。方法：根据系统评价和荟萃分析指南的首选报告项目，检索PubMed、Embase、Web of Science和Cochrane Library等数据库，进行系统评价。纳入随机临床试验（rct），比较NPWT与其他DFUs敷料。测量的结果包括伤口愈合时间和速率、肉芽组织形成时间、截肢率和不良事件。采用Cochrane偏倚风险工具评价研究质量。分析利用χ 2， i2，固定或随机效应模型通过Stata v17。结果：在纳入的1101篇文章中，选择了9篇rct进行meta分析。研究时间从2005年到2020年，来自美国、智利、巴基斯坦、意大利、印度和德国等国。meta分析显示，NPWT显著改善了伤口愈合率[风险比(RR) = 1.46, 95%CI: 1.22-1.76, P < 0.01]，降低了截肢率（RR = 0.69, 95%CI: 0.50-0.96, P = 0.006）。肉芽组织形成时间平均缩短19.54 d。然而，不良事件的发生率在NPWT和对照治疗之间没有显著差异。结论：NPWT能显著提高dfu的创面愈合率，降低截肢率。它还会加速肉芽组织的形成。然而，与替代疗法相比，该疗法并没有显著改变不良事件的风险。
Efficacy and safety of negative pressure wound therapy for the treatment of diabetic foot ulcers: A meta-analysis.
Background: Diabetic foot ulcers (DFUs) are a significant challenge in diabetic care, and the efficacy of negative pressure wound therapy (NPWT) in treating them remains a subject of continuous investigation.
Aim: To provide a comprehensive meta-analysis of the role of NPWT in the management of DFUs.
Methods: A systematic review was performed based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, searching databases like PubMed, Embase, Web of Science, and the Cochrane Library. Randomized clinical trials (RCTs) were included to compare NPWT to other dressings for DFUs. Outcomes measured were wound healing time and rate, granulation tissue formation time, amputation rate, and adverse events. Study quality was evaluated using Cochrane's risk of bias tool. Analyses utilized χ2, I2, fixed or random-effects models via Stata v17.
Results: Of the 1101 identified articles, 9 RCTs were selected for meta-analysis. Studies spanned from 2005 to 2020 and originated from countries including the United States, Chile, Pakistan, Italy, India, and Germany. Meta-analysis demonstrated a significant improvement in wound healing rate [risk ratio (RR) = 1.46, 95%CI: 1.22-1.76, P < 0.01] and a reduction in amputation rate (RR = 0.69, 95%CI: 0.50-0.96, P = 0.006) with NPWT. Furthermore, the time for granulation tissue formation was significantly reduced by an average of 19.54 days. However, the incidence of adverse events did not significantly differ between NPWT and control treatments.
Conclusion: NPWT significantly improves wound healing rates and reduces amputation rates in DFUs. It also hastens the formation of granulation tissue. However, the therapy does not significantly alter the risk of adverse events compared to alternate treatments.
期刊介绍：
The WJD is a high-quality, peer reviewed, open-access journal. The primary task of WJD is to rapidly publish high-quality original articles, reviews, editorials, and case reports in the field of diabetes. In order to promote productive academic communication, the peer review process for the WJD is transparent; to this end, all published manuscripts are accompanied by the anonymized reviewers’ comments as well as the authors’ responses. The primary aims of the WJD are to improve diagnostic, therapeutic and preventive modalities and the skills of clinicians and to guide clinical practice in diabetes. Scope: Diabetes Complications, Experimental Diabetes Mellitus, Type 1 Diabetes Mellitus, Type 2 Diabetes Mellitus, Diabetes, Gestational, Diabetic Angiopathies, Diabetic Cardiomyopathies, Diabetic Coma, Diabetic Ketoacidosis, Diabetic Nephropathies, Diabetic Neuropathies, Donohue Syndrome, Fetal Macrosomia, and Prediabetic State.
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