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Efficacy of Topical Wound Oxygen Therapy in Healing Chronic Diabetic Foot Ulcers: Systematic Review and Meta-Analysis
OBJECTIVE: To conduct a systematic review and meta-analysis of recently published randomized controlled trials (RCTs) that employed the use of topical oxygen therapy (TOT) as an adjunct therapy in the treatment of Wagner 1 and 2 diabetic foot ulcers. APPROACH: Following a literature search of eligib...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Mary Ann Liebert, Inc., publishers
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9885545/ https://www.ncbi.nlm.nih.gov/pubmed/35593010 http://dx.doi.org/10.1089/wound.2022.0041 |
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author | Carter, Marissa J. Frykberg, Robert G. Oropallo, Alisha Sen, Chandan K. Armstrong, David G. Nair, Harikrishna K.R. Serena, Thomas E. |
author_facet | Carter, Marissa J. Frykberg, Robert G. Oropallo, Alisha Sen, Chandan K. Armstrong, David G. Nair, Harikrishna K.R. Serena, Thomas E. |
author_sort | Carter, Marissa J. |
collection | PubMed |
description | OBJECTIVE: To conduct a systematic review and meta-analysis of recently published randomized controlled trials (RCTs) that employed the use of topical oxygen therapy (TOT) as an adjunct therapy in the treatment of Wagner 1 and 2 diabetic foot ulcers. APPROACH: Following a literature search of eligible studies from 2010 onward, four RCTs were included. Studies were analyzed for patient and wound characteristics, outcomes, risk of bias, and quality of the evidence assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. A random-effects meta-analysis for complete wound healing was carried out due to statistical heterogeneity of included studies. RESULTS: Risk of bias judgment (RoB2 analysis) resulted in one low-risk trial and three trials with some risk. One study was determined to be the origin of the statistical heterogeneity. Pooled results showed statistical significance with a risk ratio (RR) of 1.59 (95% confidence interval [CI]: 1.07–2.37; p = 0.021). Sensitivity analysis, based on imputed values for missing outcomes, demonstrated that both the RR and 95% CIs changed little. The GRADE ratings for each domain were as follows: (a) risk of bias: moderate (3); (b) imprecision: moderate (2), high (1); (c) inconsistency: low (2), high (1); (d) indirectness: moderate (2), high (1); and (e) publication bias: moderate (1), high (2). Overall, the evidence was moderate. INNOVATION: Our study shows that TOT is a viable diabetic foot ulcer therapy. CONCLUSIONS: These data support the use of TOT for the treatment of chronic Wagner 1 or 2 diabetic foot ulcers in the absence of infection and ischemia. |
format | Online Article Text |
id | pubmed-9885545 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Mary Ann Liebert, Inc., publishers |
record_format | MEDLINE/PubMed |
spelling | pubmed-98855452023-02-01 Efficacy of Topical Wound Oxygen Therapy in Healing Chronic Diabetic Foot Ulcers: Systematic Review and Meta-Analysis Carter, Marissa J. Frykberg, Robert G. Oropallo, Alisha Sen, Chandan K. Armstrong, David G. Nair, Harikrishna K.R. Serena, Thomas E. Adv Wound Care (New Rochelle) Technology Advances OBJECTIVE: To conduct a systematic review and meta-analysis of recently published randomized controlled trials (RCTs) that employed the use of topical oxygen therapy (TOT) as an adjunct therapy in the treatment of Wagner 1 and 2 diabetic foot ulcers. APPROACH: Following a literature search of eligible studies from 2010 onward, four RCTs were included. Studies were analyzed for patient and wound characteristics, outcomes, risk of bias, and quality of the evidence assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. A random-effects meta-analysis for complete wound healing was carried out due to statistical heterogeneity of included studies. RESULTS: Risk of bias judgment (RoB2 analysis) resulted in one low-risk trial and three trials with some risk. One study was determined to be the origin of the statistical heterogeneity. Pooled results showed statistical significance with a risk ratio (RR) of 1.59 (95% confidence interval [CI]: 1.07–2.37; p = 0.021). Sensitivity analysis, based on imputed values for missing outcomes, demonstrated that both the RR and 95% CIs changed little. The GRADE ratings for each domain were as follows: (a) risk of bias: moderate (3); (b) imprecision: moderate (2), high (1); (c) inconsistency: low (2), high (1); (d) indirectness: moderate (2), high (1); and (e) publication bias: moderate (1), high (2). Overall, the evidence was moderate. INNOVATION: Our study shows that TOT is a viable diabetic foot ulcer therapy. CONCLUSIONS: These data support the use of TOT for the treatment of chronic Wagner 1 or 2 diabetic foot ulcers in the absence of infection and ischemia. Mary Ann Liebert, Inc., publishers 2023-04-01 2023-01-18 /pmc/articles/PMC9885545/ /pubmed/35593010 http://dx.doi.org/10.1089/wound.2022.0041 Text en © Marissa J. Carter et al., 2023; Published by Mary Ann Liebert, Inc. https://creativecommons.org/licenses/by-nc/4.0/This Open Access article is distributed under the terms of the Creative Commons Attribution Noncommercial License [CC-BY-NC] (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and the source are cited. |
spellingShingle | Technology Advances Carter, Marissa J. Frykberg, Robert G. Oropallo, Alisha Sen, Chandan K. Armstrong, David G. Nair, Harikrishna K.R. Serena, Thomas E. Efficacy of Topical Wound Oxygen Therapy in Healing Chronic Diabetic Foot Ulcers: Systematic Review and Meta-Analysis |
title | Efficacy of Topical Wound Oxygen Therapy in Healing Chronic Diabetic Foot Ulcers: Systematic Review and Meta-Analysis |
title_full | Efficacy of Topical Wound Oxygen Therapy in Healing Chronic Diabetic Foot Ulcers: Systematic Review and Meta-Analysis |
title_fullStr | Efficacy of Topical Wound Oxygen Therapy in Healing Chronic Diabetic Foot Ulcers: Systematic Review and Meta-Analysis |
title_full_unstemmed | Efficacy of Topical Wound Oxygen Therapy in Healing Chronic Diabetic Foot Ulcers: Systematic Review and Meta-Analysis |
title_short | Efficacy of Topical Wound Oxygen Therapy in Healing Chronic Diabetic Foot Ulcers: Systematic Review and Meta-Analysis |
title_sort | efficacy of topical wound oxygen therapy in healing chronic diabetic foot ulcers: systematic review and meta-analysis |
topic | Technology Advances |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9885545/ https://www.ncbi.nlm.nih.gov/pubmed/35593010 http://dx.doi.org/10.1089/wound.2022.0041 |
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