With this technique, an open-cell foam dressing is placed into the wound cavity and a controlled subatmospheric pressure is applied to suck fluid from the wound, with the intention of improving wound healing. Negative pressure wound therapy (NPWT), also called vacuum-assisted wound closure, was introduced into clinical practice in the early 1990s. Publication bias is an important problem in studies on NPWT, underlining that all clinical studies need to be fully reported.Ĭhronic wounds affect about 1% of the population in Western industrialised countries, with much higher rates in inpatient settings, and pose a serious risk to patients’ health and quality of life. The data show no advantages or disadvantages of NPWT for other patient-relevant outcomes. The length of hospital stay is also shortened. In summary, low-quality data indicate a greater benefit of NPWT versus SWT for wound closure in patients with wounds healing by secondary intention. There was neither proof (nor indication nor hint) of greater benefit or harm of NPWT for other patient-relevant outcomes such as mortality and adverse events. As further analyses of different definitions of hospital stay/readmission did not contradict that analysis, we inferred an indication of a greater benefit of NPWT. A meta-analysis of hospital stay (in days) showed a significant difference in favour of NPWT (MD − 4.78, 95% CI − 7.79 to − 1.76, p = 0.005). As further analyses of different definitions of wound closure did not contradict that analysis, we inferred an indication of a greater benefit of NPWT. A meta-analysis of all wound healing data showed a significant effect in favour of NPWT (OR 1.56, 95% CI 1.15 to 2.13, p = 0.008). Due to potential publication bias (proportion of inaccessible data, 24%), we downgraded our conclusions. We identified 48 eligible studies of generally low quality with evaluable data for 4315 patients and 30 eligible studies with missing data for at least 1386 patients. We assessed publication bias and, if feasible, performed meta-analyses, grading the results into different categories (hint, indication or proof of a greater benefit or harm). Eligible studies investigated at least one patient-relevant outcome (e.g. Manufacturers and investigators were asked to provide unpublished data. We searched for RCTs in MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, and study registries (last search: July 2018) and screened reference lists of relevant systematic reviews and health technology assessments. We performed a systematic review of randomised controlled trials (RCTs) comparing the patient-relevant benefits and harms of NPWT with standard wound therapy (SWT) in patients with wounds healing by secondary intention. Negative pressure wound therapy (NPWT) is a widely used method of wound treatment.
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