Deng YX, Wang XC, Xia ZY, Wan MY, Jiang DY. Efficacy and safety of negative pressure wound therapy for the treatment of diabetic foot ulcers: A meta-analysis. World J Diabetes 2025; 16(6): 103520 [DOI: 10.4239/wjd.v16.i6.103520]
Corresponding Author of This Article
Du-Yin Jiang, MD, Emergency Medicine Center, The Second Hospital of Shandong University, No. 247 Beiyuan Street, Jinan 250033, Shandong Province, China. duyinjiang0227@yeah.net
Research Domain of This Article
Endocrinology & Metabolism
Article-Type of This Article
Meta-Analysis
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Yun-Xiang Deng, Zhen-Yu Xia, Meng-Ya Wan, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong Province, China
Xiao-Chuan Wang, Department of Plastic Surgery & Burns, The Second Hospital of Shandong University, Jinan 250033, Shandong Province, China
Du-Yin Jiang, Emergency Medicine Center, The Second Hospital of Shandong University, Jinan 250033, Shandong Province, China
Author contributions: Deng YX, Wang XC and Xia ZY conceptualized the study; Deng YX and Wan MY curated the data; Deng YX, Wang XC, and Wan MY conducted the formal analysis; Deng YX and Xia ZY developed the methodology; Deng YX and Wang XC provided resources; Deng YX and Xia ZY were responsible for software implementation; Deng YX drafted the original manuscript, and Jiang DY performed the review and editing.
Supported by the National Natural Science Foundation of China, No. 82202454 and No. 81873934; the Wang Zhengguo Trauma Medicine Fund (Growth Factor Revival Plan) No. SZYZ-TR-09; the Shandong Provincial Natural Science Foundation Youth Fund, No. ZR2020QH168; and the Jinan Science and Technology Plan Project, No. 202225065.
Conflict-of-interest statement: The authors declare that they have no competing interests.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Du-Yin Jiang, MD, Emergency Medicine Center, The Second Hospital of Shandong University, No. 247 Beiyuan Street, Jinan 250033, Shandong Province, China. duyinjiang0227@yeah.net
Received: November 22, 2024 Revised: March 4, 2025 Accepted: April 10, 2025 Published online: June 15, 2025 Processing time: 204 Days and 2.8 Hours
Abstract
BACKGROUND
Diabetic foot ulcers (DFUs) are a significant challenge in diabetic care, and the efficacy of negative pressure wound therapy (NPWT) in treating them remains a subject of continuous investigation.
AIM
To provide a comprehensive meta-analysis of the role of NPWT in the management of DFUs.
METHODS
A systematic review was performed based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, searching databases like PubMed, Embase, Web of Science, and the Cochrane Library. Randomized clinical trials (RCTs) were included to compare NPWT to other dressings for DFUs. Outcomes measured were wound healing time and rate, granulation tissue formation time, amputation rate, and adverse events. Study quality was evaluated using Cochrane's risk of bias tool. Analyses utilized χ2, I2, fixed or random-effects models via Stata v17.
RESULTS
Of the 1101 identified articles, 9 RCTs were selected for meta-analysis. Studies spanned from 2005 to 2020 and originated from countries including the United States, Chile, Pakistan, Italy, India, and Germany. Meta-analysis demonstrated a significant improvement in wound healing rate [risk ratio (RR) = 1.46, 95%CI: 1.22-1.76, P < 0.01] and a reduction in amputation rate (RR = 0.69, 95%CI: 0.50-0.96, P = 0.006) with NPWT. Furthermore, the time for granulation tissue formation was significantly reduced by an average of 19.54 days. However, the incidence of adverse events did not significantly differ between NPWT and control treatments.
CONCLUSION
NPWT significantly improves wound healing rates and reduces amputation rates in DFUs. It also hastens the formation of granulation tissue. However, the therapy does not significantly alter the risk of adverse events compared to alternate treatments.
Core Tip: This comprehensive meta-analysis synthesizes data from randomized controlled trials to evaluate the impact of negative pressure wound therapy (NPWT) on diabetic foot ulcers, a prevalent and challenging complication in diabetic care. Our analysis not only reaffirms the efficacy of NPWT in enhancing wound healing rates and reducing amputation risks but also emphasizes its role in accelerating granulation tissue formation without increasing adverse events.
