Negative pressure wound therapy versus gauze dressings in managing open fracture wound of lower limbs: A meta-analysis of randomized controlled trials |
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| Affiliation: | 1. Department of Orthopeadic Surgery, Xiangya Hospital Central South University, China;2. Department of Orthopedic Surgery, The First Affliated Hospital, College of Medicine, Zhejiang University, China;3. Hunan Engineering Research Center of Biomedical Metal and Ceramic Implants, China;1. Beaumont Hospital, Royal Oak, MI, USA;2. University of Iowa, Carver College of Medicine, Department of Orthopedics and Rehabilitation, Iowa City, IA, USA;3. Federal University of Sao Paulo, Department of Orthopedics and Traumatology, Sao Paulo, SP, Brazil;4. Department of Orthopedic Surgery, Rouen University Hospital, Rouen, France;5. University of Sao Paulo, Department of Orthopedics and Traumatology, Sao Paulo, SP, Brazil;1. Hospital for Special Surgery, 532 East 72nd Street, 5th Floor, New York, NY 10021, United States;2. Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, United States;1. The First Affiliated Hospital of Chongqing Medical University, China;2. Shanqi (Chongqing) Smart Medical Technology Co., Ltd., China;3. Chongqing Orthopaedic Hospital of traditional Chinese Medicine, China;1. Department of Orthopaedic Surgery, Faculty of Medicine, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi, Japan;2. Center for Birth Cohort Studies, Interdisciplinary Graduate School of Medicine, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi, Japan;1. Department of Orthopedic Surgery, Clinique Rive Gauche, 49 allée Charles de Fitte, 31300 Toulouse, France;2. Department of Orthopedic Surgery, Jose R. Reyes Memorial Medical Center San Lazaro Compound, Rizal Avenue Sta. Cruz, Manila, Metro Manila 1012, Philippines |
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| Abstract: | BackgroundThe superiority of negative pressure wound therapy (NPWT) to standard gauze dressings for managing open fractures of the lower limbs remains controversial. This study aimed to comprehensively compare their clinical efficacy through a meta-analysis using randomized controlled trials (RCTs) alone. We hypothesized that NPWT would be more superior against infections.MethodsA literature search was implemented in various databases, including PubMed, Web of Science, Medline, Clinicaltrial.gov, and Cochrane Library, etc, to screen eligible RCTs. All included RCTs were evaluated for risk of bias using the Cochrane Collaboration tool. In accordance with the heterogeneity assessment, a fixed-effect or random-effect model was chosen for the data analysis.ResultsTen RCTs, including 2780 patients, were eligible for the meta-analysis. We found that patients in the NPWT group showed a lower overall infection rate (MD=0.70, 95% CI: 0.54–0.90, P = 0.005), acute wound infection rate (MD = 0.35, 95% CI: 0.16–0.77, P = 0.009), and shorter hospital stay (MD = 24.00, 95% CI: 6.82–84.46, P < 0.00001) compared with the control group. The NPWT group showed a higher proportion of patients with wound coverage than the control group. No significant difference was found between the two groups in terms of function score and other complications, including deep infection rate, amputation, and bone nonunion.ConclusionsFrom the pooled results, we suggest that NPWT may be superior than traditional gauze dressings for managing open fractures of the lower limbs. |
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| Keywords: | Open fracture Negative pressure wound therapy Standard gauze dressing Meta-analysis Randomized controlled trials |
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