Adjunctive hyperbaric oxygen therapy and negative pressure wound therapy for hard-to-heal wounds: a systematic review and meta-analysis.

IF 1.5 4区医学 Q3 DERMATOLOGY Journal of wound care Pub Date : 2024-12-02 DOI:10.12968/jowc.2022.0213

Liehao Yang, Jiao Kong, Yunlong Xing, Lingfeng Pan, Caihong Li, Zhuoxia Wu, Mingxi Li, Lianbo Zhang

{"title":"Adjunctive hyperbaric oxygen therapy and negative pressure wound therapy for hard-to-heal wounds: a systematic review and meta-analysis.","authors":"Liehao Yang, Jiao Kong, Yunlong Xing, Lingfeng Pan, Caihong Li, Zhuoxia Wu, Mingxi Li, Lianbo Zhang","doi":"10.12968/jowc.2022.0213","DOIUrl":null,"url":null,"abstract":"Objective: Negative pressure wound therapy (NPWT) and hyperbaric oxygen therapy (HBOT) have been widely used in the treatment of hard-to-heal (chronic) wounds, but there is still a lack of sufficient evidence for their combined use for the treatment of hard-to-heal wounds. This systematic review aimed to identify the clinical efficacy and safety of adding adjunctive HBOT to NPWT for hard-to-heal wounds.Method: Embase, PubMed, Cochrane Library, Web of Science, China National Knowledge Infrastructure and Wanfang were searched from the establishment of the database to March 2022. The literature was screened according to the inclusion criteria and exclusion criteria. We assessed the quality of each included study with the Cochrane Collaboration Risk of Bias tool and Newcastle-Ottawa Scale. A meta-analysis was performed using R programming software version 4.1.0 (R Project for Statistical Computing, US). The PRISMA 2020 guidelines were used to report data from systematic reviews and meta-analysis.Results: A total of 15 studies were identified, including nine randomised clinical controlled trials and six retrospective studies. Meta-analysis results showed that NPWT combined with HBOT had better outcomes compared with the NPWT alone with regards to: wound healing rate (odds ratio (OR)=6.77; 95% confidence interval (Cl): 3.53-12.98; p<0.0001); bacterial positive rate of wound (OR=0.16; 95% CI: 0.05-0.55; p=0.0037); wound healing time (mean difference (MD)= -3.86; 95% Cl: -5.18 - -2.53; p<0.0001); wound area (standardised mean difference (SMD)=1.50; 95% Cl: 0.35-2.65; p=0.0104); hospitalisation time (MD= -3.14; 95% Cl: -4.93 - -1.36; p=0.005); and hospitalisation cost (OR= -202.64; 95% Cl: -404.53 - -0.75; p=0.0492). There was no significant difference in pain score (MD= -0.43; 95% Cl: -1.15-0.30; p=0.25).Conclusion: The findings of this study demonstrated that adjunctive HBOT with NPWT is safe and effective in the treatment of hard-to-heal wounds. However, these findings should be interpreted with great caution given the limitations of the studies included.","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"33 12","pages":"950-957"},"PeriodicalIF":1.5000,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of wound care","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.12968/jowc.2022.0213","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"DERMATOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Objective: Negative pressure wound therapy (NPWT) and hyperbaric oxygen therapy (HBOT) have been widely used in the treatment of hard-to-heal (chronic) wounds, but there is still a lack of sufficient evidence for their combined use for the treatment of hard-to-heal wounds. This systematic review aimed to identify the clinical efficacy and safety of adding adjunctive HBOT to NPWT for hard-to-heal wounds.

Method: Embase, PubMed, Cochrane Library, Web of Science, China National Knowledge Infrastructure and Wanfang were searched from the establishment of the database to March 2022. The literature was screened according to the inclusion criteria and exclusion criteria. We assessed the quality of each included study with the Cochrane Collaboration Risk of Bias tool and Newcastle-Ottawa Scale. A meta-analysis was performed using R programming software version 4.1.0 (R Project for Statistical Computing, US). The PRISMA 2020 guidelines were used to report data from systematic reviews and meta-analysis.

Results: A total of 15 studies were identified, including nine randomised clinical controlled trials and six retrospective studies. Meta-analysis results showed that NPWT combined with HBOT had better outcomes compared with the NPWT alone with regards to: wound healing rate (odds ratio (OR)=6.77; 95% confidence interval (Cl): 3.53-12.98; p<0.0001); bacterial positive rate of wound (OR=0.16; 95% CI: 0.05-0.55; p=0.0037); wound healing time (mean difference (MD)= -3.86; 95% Cl: -5.18 - -2.53; p<0.0001); wound area (standardised mean difference (SMD)=1.50; 95% Cl: 0.35-2.65; p=0.0104); hospitalisation time (MD= -3.14; 95% Cl: -4.93 - -1.36; p=0.005); and hospitalisation cost (OR= -202.64; 95% Cl: -404.53 - -0.75; p=0.0492). There was no significant difference in pain score (MD= -0.43; 95% Cl: -1.15-0.30; p=0.25).

Conclusion: The findings of this study demonstrated that adjunctive HBOT with NPWT is safe and effective in the treatment of hard-to-heal wounds. However, these findings should be interpreted with great caution given the limitations of the studies included.

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

辅助高压氧治疗和负压伤口治疗难以愈合的伤口：系统回顾和荟萃分析。

目的：负压创面治疗（NPWT）和高压氧治疗（HBOT）已广泛应用于难愈合（慢性）创面的治疗，但两者联合应用于难愈合创面的治疗仍缺乏足够的证据。本系统综述旨在确定在NPWT中添加辅助HBOT治疗难愈合伤口的临床疗效和安全性。方法：检索Embase、PubMed、Cochrane Library、Web of Science、中国知网、万方等自建库至2022年3月的文献。根据纳入标准和排除标准对文献进行筛选。我们使用Cochrane协作偏倚风险工具和纽卡斯尔-渥太华量表评估每项纳入研究的质量。采用R编程软件4.1.0（美国R Project for Statistical Computing）进行meta分析。PRISMA 2020指南用于报告系统评价和荟萃分析的数据。结果：共纳入15项研究，包括9项随机临床对照试验和6项回顾性研究。meta分析结果显示，NPWT联合HBOT在以下方面优于单独NPWT：伤口愈合率(优势比(OR)=6.77；95%置信区间（Cl）： 3.53-12.98；结论：本研究结果表明，NPWT辅助HBOT治疗难愈合创面安全有效。然而，考虑到所纳入研究的局限性，对这些发现的解释应非常谨慎。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

Journal of wound care DERMATOLOGY-

CiteScore

2.90

自引率

10.50%

发文量

215

期刊介绍： Journal of Wound Care (JWC) is the definitive wound-care journal and the leading source of up-to-date research and clinical information on everything related to tissue viability. The journal was first launched in 1992 and aimed at catering to the needs of the multidisciplinary team. Published monthly, the journal’s international audience includes nurses, doctors and researchers specialising in wound management and tissue viability, as well as generalists wishing to enhance their practice. In addition to cutting edge and state-of-the-art research and practice articles, JWC also covers topics related to wound-care management, education and novel therapies, as well as JWC cases supplements, a supplement dedicated solely to case reports and case series in wound care. All articles are rigorously peer-reviewed by a panel of international experts, comprised of clinicians, nurses and researchers. Specifically, JWC publishes: High quality evidence on all aspects of wound care, including leg ulcers, pressure ulcers, the diabetic foot, burns, surgical wounds, wound infection and more The latest developments and innovations in wound care through both preclinical and preliminary clinical trials of potential new treatments worldwide In-depth prospective studies of new treatment applications, as well as high-level research evidence on existing treatments Clinical case studies providing information on how to deal with complex wounds Comprehensive literature reviews on current concepts and practice, including cost-effectiveness Updates on the activities of wound care societies around the world.