Topical negative pressure for treating chronic wounds: a systematic review

• Published in: British journal of plastic surgery Vol. 54; no. 3; pp. 238 - 242
• Main Authors: Evans, Debra, Land, Lucy
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01.04.2001; Elsevier
• Subjects: Biological and medical sciences; Chronic Disease; chronic wound; Databases, Bibliographic; healing; Humans; Injuries of the skin. Diseases of the skin due to physical agents; Medical sciences; Occlusive Dressings; randomised controlled trial; Randomized Controlled Trials as Topic; topical negative pressure; Traumas. Diseases due to physical agents; Vacuum; Wound Healing; Wounds and Injuries - therapy; healing; randomised controlled trial; topical negative pressure; chronic wound; Human; Skin disease; Chronic; Treatment; Clinical trial; Skin; Review; Negative pressure; Trauma; Wound; Topical administration
• ISSN: 0007-1226; 1465-3087
• DOI: 10.1054/bjps.2001.3547

Some wounds take a long time to heal, fail to heal or recur, causing significant pain and discomfort to thepatient and cost to the National Health Service. This review assesses the effectiveness of topical negative pressure (TNP) in treating chronic wounds. The Cochrane Wounds Group Specialised Trials Register was searched for randomised controlled trials (RCTs) that evaluated the effectiveness of TNP on chronic-wound healing. Eligibility for inclusion, data extraction and details of trial quality were conducted by two reviewers independently. A narrative synthesis of results was undertaken as only two small trials, with different outcome measures, fulfilled the selection criteria. Trial 1 considered any type of chronic wound, trial 2 considered diabetic foot ulcers. Both trials compared TNP with saline-gauze dressings. Trial 1 reported a statistically significant difference in the percentage change in wound volume after 6 weeks, in favour of TNP. Trial 2 reported a difference in the number of days to healing and a difference in the percentage change in wound surface area after 2 weeks, in favour of TNP. These two small trials provide weak evidence to suggest that TNP may be superior to saline-gauze dressings in terms of wound healing. However, due to the small sample sizes and the methodological limitations of the studies, these findings must be interpreted with extreme caution. The effects of TNP on cost, quality of life, pain and comfort were not reported. It was not possible to determine the optimum TNP regimen. Further high-quality RCTs that address these issues are required.