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

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).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.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).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.