Negative-pressure therapy versus standard wound care: a meta-analysis of randomized trials.
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.


METHODS
Therapeutic, II.
Montreal, Quebec, Canada From the Université de Montréal, Division of Plastic Surgery, Hôpital Notre-Dame.
Daniel
D
Suissa
Alain
A
Danino
Andreas
A
Nikolis
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001458:Bandages; D002908:Chronic Disease; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008297:Male; D054843:Negative-Pressure Wound Therapy / Q000379:methods*; D003668:Pressure Ulcer / Q000628:therapy; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D012720:Severity of Illness Index; D017592:Skin Care / Q000379:methods; D013529:Surgical Wound Dehiscence / Q000628:therapy; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology*; D014947:Wounds and Injuries / Q000175:diagnosis* / Q000628:therapy*
D000900:Anti-Bacterial Agents