title: Effectiveness and safety of negative-pressure wound therapy for diabetic foot ulcers: a meta-analysis.
abstract: BACKGROUND
  The authors conducted a meta-analysis to evaluate the effectiveness and safety of negative-pressure wound therapy for diabetic foot ulcers.
  
  
  METHODS
  PubMed, EMBASE, and the Cochrane Library were searched to identify relevant studies published up to February of 2013. All randomized controlled trials comparing negative-pressure wound therapy and non-negative-pressure wound therapy (i.e., standard wound care) for diabetic foot ulcers were included. Results were pooled using meta-analysis to assess the efficacy and safety of negative pressure in managing diabetic foot ulcers.
  
  
  RESULTS
  The databases were derived from eight qualified studies that included a total of 669 patients. Overall, compared with the non-negative-pressure wound therapy-treated diabetic foot ulcers, negative pressure resulted in a significantly higher proportion of healed ulcers (relative risk, 1.52; 95 percent CI, 1.23 to 1.89; p<0.001), more reduction of ulcer area (standardized mean difference, 0.89; 95 percent CI, 0.41 to 1.37; p=0.003), and shorter time to wound healing (standardized mean difference, -1.10; 95 percent CI, -1.83 to -0.37; p=0.003). Negative-pressure wound therapy patients also experienced significantly fewer major amputations (relative risk, 0.14; 95 percent CI, 0.04 to 0.51; p=0.003), but the rate of minor amputations was not affected (p=0.837). No significant difference was observed between negative-pressure wound therapy and non-negative-pressure wound therapy (p=0.683). No heterogeneity among studies was detected.
  
  
  CONCLUSIONS
  Negative-pressure wound therapy appears to be more effective for diabetic foot ulcers compared with non-negative-pressure wound therapy, and has a similar safety profile.
  
  
  METHODS
  Therapeutic, II.
authors.affiliation: Guangzhou, People's Republic of China From the Departments of Burns and Plastic Surgery and Hepatobiliary Surgery, The First Affiliated Hospital of Sun Yat-sen University; and the Department of Plastic Surgery, The Third Affiliated Hospital of Sun Yat-sen University.
authors.forename: Jian
authors.initials: J
authors.lastname: Zhang
authors.forename: Zhi-Cheng
authors.initials: ZC
authors.lastname: Hu
authors.forename: Dong
authors.initials: D
authors.lastname: Chen
authors.forename: Dong
authors.initials: D
authors.lastname: Guo
authors.forename: Jia-Yuan
authors.initials: JY
authors.lastname: Zhu
authors.forename: Bing
authors.initials: B
authors.lastname: Tang
mesh_terms: D017719:Diabetic Foot / Q000628:therapy*; D006801:Humans; D054843:Negative-Pressure Wound Therapy / Q000009:adverse effects; D012074:Remission Induction