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Negative-Pressure Therapy versus Standard Wound Care: A Meta-Analysis of Randomized Trials

Suissa, Daniel M.D., M.Sc.; Danino, Alain M.D., Ph.D.; Nikolis, Andreas M.D., M.Sc.

doi: 10.1097/PRS.0b013e31822b675c
Reconstructive: Trunk: Original Articles

Background: Several randomized controlled trials comparing negative-pressure therapy to standard wound care for chronic wounds have been published. Although these studies suggest a benefit for negative-pressure therapy, the majority of the review articles on the topic conclude that the studies are inconclusive. The authors conducted a quantitative meta-analysis of the effectiveness of negative-pressure therapy for the management of chronic wounds.

Methods: The MEDLINE, EMBASE, and Cochrane databases were searched from 1993 to March of 2010 for randomized controlled trials comparing negative-pressure therapy to standard wound care for chronic wounds. Measures of wound size and time to healing, along with the corresponding p values, were extracted from the randomized controlled trials. Relative change ratios of wound size and ratios of median time to healing were combined using a random effects model for meta-analysis.

Results: Ten trials of negative-pressure therapy versus standard wound care were found. In the negative-pressure therapy group, wound size had decreased significantly more than in the standard wound care group (relative change ratio, 0.77; 95 percent confidence interval, 0.63 to 0.96). Time to healing was significantly shorter in the negative-pressure therapy group in comparison with the standard wound care group (ratio of median time to healing, 0.74; 95 percent confidence interval, 0.70 to 0.78).

Conclusions: This quantitative meta-analysis of randomized trials suggests that negative-pressure therapy appears to be an effective treatment for chronic wounds. An effect of publication bias cannot be ruled out.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, II.

Montreal, Quebec, Canada

From the Université de Montréal, Division of Plastic Surgery, Hôpital Notre-Dame.

Received for publication November 21, 2010; accepted May 17, 2011.

Disclosure: The authors have no financial interest to declare in relation to the content of this article. No outside funding was received.

Daniel Suissa, M.D., M.Sc.; 840 Car Stewart, Montreal, Quebec H4M 2X2, Canada, daniel.suissa@umontreal.ca

©2011American Society of Plastic Surgeons