Effects of Negative-Pressure Wound Therapy With Instillation versus Standard of Care in Multiple Wound Types: Systematic Literature Review and Meta-Analysis.
Bacteria
/ isolation & purification
Bacterial Load
Bandages
Debridement
/ statistics & numerical data
Humans
Length of Stay
/ statistics & numerical data
Multiple Trauma
/ complications
Negative-Pressure Wound Therapy
/ instrumentation
Standard of Care
Therapeutic Irrigation
/ instrumentation
Time Factors
Treatment Outcome
Wound Healing
Wound Infection
/ microbiology
Journal
Plastic and reconstructive surgery
ISSN: 1529-4242
Titre abrégé: Plast Reconstr Surg
Pays: United States
ID NLM: 1306050
Informations de publication
Date de publication:
01 01 2021
01 01 2021
Historique:
entrez:
21
12
2020
pubmed:
22
12
2020
medline:
14
5
2021
Statut:
ppublish
Résumé
Large randomized controlled trials that evaluate the effects of negative-pressure wound therapy with instillation of a topical solution and dwell time (NPWTi-d) are lacking. There is a need to synthesize existing data across multiple studies to provide a more precise estimate of the clinical effects of NPWTi-d. A systematic literature review and a meta-analysis of comparative studies were performed to determine the effects of NPWTi-d versus control therapy in the adjunctive management of complex wounds. Weighted standardized mean difference or odds ratios and 95% confidence intervals were calculated to pool study and control group results in each publication for analysis. Thirteen studies comprising 720 patients were included in the analysis. Significantly fewer surgical debridements were performed in NPWTi-d patients versus control patients (P = 0.01). Wounds in the NPWTi-d group were ready for closure faster than control wounds (P = 0.03). The odds of reducing bacterial count from baseline in the NPWTi-d group was 4.4 times greater than control group wounds (P = 0.003), and percent reduction of bacterial count in NPWTi-d wounds was evident in all studies that captured that endpoint. There was a significantly shorter length of therapy in NPWTi-d patients versus control patients (P = 0.03). Wounds in NPWTi-d group were 2.39 times more likely to close than control group wounds (P = 0.01). Length of hospital stay was not significantly reduced for NPWTi-d patients compared with that for control patients (P = 0.06). Results of this meta-analysis show a positive effect with use of NPWTi-d in various wound types.
Sections du résumé
BACKGROUND
Large randomized controlled trials that evaluate the effects of negative-pressure wound therapy with instillation of a topical solution and dwell time (NPWTi-d) are lacking. There is a need to synthesize existing data across multiple studies to provide a more precise estimate of the clinical effects of NPWTi-d.
METHODS
A systematic literature review and a meta-analysis of comparative studies were performed to determine the effects of NPWTi-d versus control therapy in the adjunctive management of complex wounds. Weighted standardized mean difference or odds ratios and 95% confidence intervals were calculated to pool study and control group results in each publication for analysis.
RESULTS
Thirteen studies comprising 720 patients were included in the analysis. Significantly fewer surgical debridements were performed in NPWTi-d patients versus control patients (P = 0.01). Wounds in the NPWTi-d group were ready for closure faster than control wounds (P = 0.03). The odds of reducing bacterial count from baseline in the NPWTi-d group was 4.4 times greater than control group wounds (P = 0.003), and percent reduction of bacterial count in NPWTi-d wounds was evident in all studies that captured that endpoint. There was a significantly shorter length of therapy in NPWTi-d patients versus control patients (P = 0.03). Wounds in NPWTi-d group were 2.39 times more likely to close than control group wounds (P = 0.01). Length of hospital stay was not significantly reduced for NPWTi-d patients compared with that for control patients (P = 0.06).
CONCLUSION
Results of this meta-analysis show a positive effect with use of NPWTi-d in various wound types.
Identifiants
pubmed: 33347065
doi: 10.1097/PRS.0000000000007614
pii: 00006534-202101001-00011
doi:
Types de publication
Comparative Study
Journal Article
Meta-Analysis
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
68S-76SInformations de copyright
Copyright © 2020 by the American Society of Plastic Surgeons.
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