SLR - February 2012 - Stephen C. Schmid
Reference: Suissa D, Danino A, and Nikolis A. Plast Reconstr Surg, 128(5): 498e-503e, 2011.
Scientific Literature Review
Reviewed By: Stephen C. Schmid, DPM
Residency Program: Detroit Medical Center
Podiatric Relevance:
Negative pressure therapy has become a popular modality for stimulating healing in open wounds. Several randomized controlled trials comparing negative-pressure therapy to standard wound therapy for chronic wounds have been published. Many of these studies suggest a benefit for negative-pressure therapy. However, a majority of the review articles on the topic conclude that the studies are inconclusive.
Methods:
Randomized control trials comparing negative-pressure therapy to standard wound care for chronic wounds were searched in MEDLINE, EMBASE and Cochrane databases from 1993 to March of 2010. Measures of wound size and time to healing along with corresponding p values were extracted. Relative change ratios of wound size and ratios of median time to healing were combined using a random effects model for meta-analysis.
Results:
A total of 10 trials were found. Wound size had decreased significantly more in the negative-pressure therapy group than the standard wound care group with a relative change ratio of 0.77 (95 percent confidence interval, 0.63 to 0.96). Time to healing was also significantly shorter in the negative-pressure therapy group in comparison with standard wound group with a ratio of median time to healing of 0.74 (95 percent confidence interval, 0.70 to 0.78).
Conclusions:
The quantitative meta-analysis of the randomized trials suggests that negative-pressure therapy appears to be effective treatment for chronic wounds. An effect of publication bias could not be ruled out.