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已发表论文
负压伤口治疗在糖尿病足溃疡中的疗效和安全性：对重叠荟萃分析的横断面分析
Authors Du Y, Zhai T, Sheng Z, Xie W, Jia Z , Wen T, Zhao X, Tong X
Received 13 September 2025
Accepted for publication 4 November 2025
Published 11 November 2025 Volume 2025:18 Pages 4099—4112
DOI https://doi.org/10.2147/DMSO.S565993
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Rebecca Baqiyyah Conway
Ying Du,1,2,* Tiangang Zhai,1,3,* Zhujun Sheng,3 Weinan Xie,3 Zhiwei Jia,2 Tianlin Wen,2 Xiyan Zhao,3 Xiaolin Tong3
1Beijing University of Chinese Medicine, Beijing, People’s Republic of China; 2Department of Orthopedics, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, People’s Republic of China; 3Department of Endocrinology, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Tianlin Wen, Department of Orthopedics, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, People’s Republic of China, Email wentianlin@bucm.edu.cn Xiaolin Tong, Department of Endocrinology, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, People’s Republic of China, Email tongxiaolin@vip.163.com
Objective: Negative pressure wound therapy (NPWT) is a key intervention for diabetic foot ulcers (DFUs). However, the body of meta-analytic evidence is fraught with conflicting findings, creating significant clinical uncertainty. This study was designed to harmonize the discordant evidence, identify the most methodologically robust meta-analysis, and formulate a clear, evidence-based recommendation for the clinical use of NPWT.
Methods: We conducted a comprehensive search of the PubMed, Embase, and Cochrane Library databases to identify all pertinent meta-analyses. The methodological quality of each included review was rigorously assessed using the Assessment of Multiple Systematic Reviews (AMSTAR) instrument. The Jadad decision algorithm was then employed to systematically select the most reliable and robust evidence.
Results: Eight meta-analyses met the inclusion criteria, with AMSTAR scores ranging from 6 to 9. The formal application of the Jadad decision algorithm identified the meta-analysis by Deng et al as the definitive source of best available evidence. This meta-analysis demonstrated that NPWT significantly improved wound healing rates (risk ratio = 1.46) and decreased amputation rates (risk ratio = 0.69) relative to conventional therapy, while also shortening granulation tissue formation time without increasing adverse events.
Conclusion: The highest-quality evidence, harmonized through this appraisal, confirms that NPWT is a safe and effective adjunctive therapy for DFUs. Its demonstrated ability to accelerate healing while reducing amputations provides a strong evidence base for consideration as a key component of standard clinical practice.
Keywords: diabetic foot ulcer, negative pressure wound therapy, vacuum-assisted closure, systematic review, meta-analysis
1Beijing University of Chinese Medicine, Beijing, People’s Republic of China; 2Department of Orthopedics, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, People’s Republic of China; 3Department of Endocrinology, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Tianlin Wen, Department of Orthopedics, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, People’s Republic of China, Email wentianlin@bucm.edu.cn Xiaolin Tong, Department of Endocrinology, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, People’s Republic of China, Email tongxiaolin@vip.163.com
Objective: Negative pressure wound therapy (NPWT) is a key intervention for diabetic foot ulcers (DFUs). However, the body of meta-analytic evidence is fraught with conflicting findings, creating significant clinical uncertainty. This study was designed to harmonize the discordant evidence, identify the most methodologically robust meta-analysis, and formulate a clear, evidence-based recommendation for the clinical use of NPWT.
Methods: We conducted a comprehensive search of the PubMed, Embase, and Cochrane Library databases to identify all pertinent meta-analyses. The methodological quality of each included review was rigorously assessed using the Assessment of Multiple Systematic Reviews (AMSTAR) instrument. The Jadad decision algorithm was then employed to systematically select the most reliable and robust evidence.
Results: Eight meta-analyses met the inclusion criteria, with AMSTAR scores ranging from 6 to 9. The formal application of the Jadad decision algorithm identified the meta-analysis by Deng et al as the definitive source of best available evidence. This meta-analysis demonstrated that NPWT significantly improved wound healing rates (risk ratio = 1.46) and decreased amputation rates (risk ratio = 0.69) relative to conventional therapy, while also shortening granulation tissue formation time without increasing adverse events.
Conclusion: The highest-quality evidence, harmonized through this appraisal, confirms that NPWT is a safe and effective adjunctive therapy for DFUs. Its demonstrated ability to accelerate healing while reducing amputations provides a strong evidence base for consideration as a key component of standard clinical practice.
Keywords: diabetic foot ulcer, negative pressure wound therapy, vacuum-assisted closure, systematic review, meta-analysis