Document Detail

A systematic review of topical negative pressure therapy for acute and chronic wounds.
MedLine Citation:
PMID:  18446777     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Topical negative pressure (TNP) therapy is becoming increasingly popular for all kinds of wounds. Its clinical and cost effectiveness is unclear. METHODS: A search of randomized controlled trials (RCTs) on TNP in adult patients with all kinds of wounds in all settings was undertaken in Medline, Embase, Cinahl (to October 2007) and the Cochrane Library (to issue 4, 2007). Information was also sought from manufacturer of the VAC device. Selection of trials for analysis, quality assessment, data abstraction and data synthesis were conducted by two authors independently. The primary endpoint was any measure of wound healing. Secondary endpoints were infection, pain, quality of life, oedema, microcirculation, bacterial load, adverse events, duration of hospital stay and cost. RESULTS: The search identified 15 publications on 13 RCTs. These reported on patients with chronic wounds, diabetic wounds, pressure ulcers, skin grafts and acute wounds. In chronic and diabetic wounds, TNP did not allow earlier complete wound healing. It was, however, associated with a 1-10 day reduction in the time needed to prepare the wound for secondary closure surgery. In one trial on acute wounds, 17 (95 per cent confidence interval (c.i.) 0.02 to 0.32) per cent more wounds appeared to heal with TNP; the number needed to treat was six. This was, however, at the cost of an 11 (95 per cent c.i. 0.01 to 0.21) per cent higher complication rate; the number needed to harm was nine. CONCLUSION: There is little evidence to support the use of TNP in the treatment of wounds.
D T Ubbink; S J Westerbos; E A Nelson; H Vermeulen
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  The British journal of surgery     Volume:  95     ISSN:  1365-2168     ISO Abbreviation:  Br J Surg     Publication Date:  2008 Jun 
Date Detail:
Created Date:  2008-05-05     Completed Date:  2008-05-27     Revised Date:  2008-09-03    
Medline Journal Info:
Nlm Unique ID:  0372553     Medline TA:  Br J Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  685-92     Citation Subset:  AIM; IM    
Copyright Information:
2008 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
Department of Quality Assurance and Process Innovation, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
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MeSH Terms
Acute Disease
Chronic Disease
Data Collection
Diabetes Complications / therapy
Negative-Pressure Wound Therapy / methods*
Pressure Ulcer / therapy
Randomized Controlled Trials as Topic
Skin Transplantation
Treatment Outcome
Wound Healing / physiology*
Wounds and Injuries / therapy*
Comment In:
Br J Surg. 2008 Sep;95(9):1185-6; author reply 1186   [PMID:  18690618 ]

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