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.
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.
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).
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.
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, firstname.lastname@example.org