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

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.

Integrating bioinformatics and multiple machine learning to identify mitophagy-related targets for the diagnosis and treatment of diabetic foot ulcers: evidence from transcriptome analysis and drug docking

“…However, the current clinical diagnosis and treatment of DFU also face challenges, with the clinical diagnosis of DFU being overly dependent on the clinical experience of clinicians and lacking effective treatments ( Armstrong et al, 2017 ; Matos et al, 2018 ; Purwanti et al, 2024 ; Wang F. et al, 2024 ; Wang K. et al, 2024 ). At the present stage, the treatment of DFU patients mainly includes debridement, wound dressing, anti-infection treatment, peripheral vasculopathy treatment, strict glycemic control, and amputation ( McIllhatton et al, 2021 ; Orlando et al, 2021 ; Ahmed et al, 2022 ; Slomski, 2022 ; Jeffcoate et al, 2024 ), but the therapeutic efficacy of these methods is still unsatisfactory and has not yet achieved a satisfactory clinical results, that is, they do not fully control the underlying metabolic lesions ( Bardill et al, 2022 ; Chen et al, 2024 ; Yi et al, 2024 ; Zhang G. et al, 2024 ; Zhang N. et al, 2024 ). Thus, it is urgent to further identify novel biomarkers of DFU to improve the current dilemma of clinical diagnosis and treatment of DFU.…”