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, firstname.lastname@example.org