Comparison of negative pressure wound therapy and moist wound care in patients with diabetic foot ulcers: A protocol for systematic review and meta-analysis of randomized controlled trials

BACKGROUND: This study conducted a meta-analysis to compare the effectiveness and safety of the negative pressure wound therapy (NPWT) with the moist wound care (MWC) in the treatment of diabetic foot ulcers (DFUs). METHODS: The PubMed, EMBASE, and CENTRAL were searched by 2 of the authors, to identify randomized controlled trials comparing the clinical outcomes of patients treated with NPWT versus MWC for DFUs. Meta-analyses were performed for several outcomes, including wound healing results, amputation or resection incidence, and risk of adverse events, utilizing the “meta” package of R language version 4.0.3. RESULTS: A total of 10 trials (619 patients in NPWT group and 625 in MWC group) and 8 trials were included for the qualitative and quantitative syntheses, respectively. As a result, significantly lower risk of non-closure of the wound (risk ratio [RR] = 0.74, 95% confidence interval [CI]: 0.63–0.87; P = .001), lower average wound area (standard mean difference = −0.80, 95% CI: −1.54 to −0.06; P = .034), more wound area decrease (standard mean difference = 0.81, 95% CI: 0.36–1.26; P = .001), increased appearance rate of granulation tissue (RR = 1.61, 95% CI: 1.07–2.41; P-0.021), and lower risk of amputation or resection (RR = 0.70, 95% CI: 0.50–0.99; P = .045), were demonstrated for the NPWT group when compared to MWC group. However, no statistically significant difference was found for the disappearance rate of wound discharge at 8 weeks, the rate of blood culture positivity, VAS-pain score, and the overall frequency of adverse events between the 2 treatment groups (P = .05). CONCLUSION: NPWT could accelerate process of the wound healing, and decrease the risk of post-treatment amputation or resection, without any additional frequency of adverse events, when compared with MWC, in patients with DFUs.