The Efficacy of Negative Pressure Wound Therapy Combined with Topical Oxygen Therapy in Treating Chronic Refractory Wounds: A Systematic Review and Meta-Analysis.
Junwei Su, Dong Zhang, Jincheng Du et al.
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In 30 seconds
This systematic review and meta-analysis assessed randomized controlled trials comparing negative pressure wound therapy (NPWT) plus topical oxygen therapy (TOT) with NPWT alone for chronic refractory wounds. Eleven trials involving 844 patients were included. Combination therapy was associated with a higher healing rate (risk ratio 1.51, 95% CI 1.36-1.69) and shorter healing time (mean difference -9.09 days, 95% CI -11.98 to -6.20). The authors conclude that adding topical oxygen may improve healing outcomes, although the substantial heterogeneity in healing time warrants caution.
Key findings
- Healing rate was higher with NPWT plus TOT than with NPWT alone (RR = 1.51, 95% CI: 1.36-1.69, I 2 = 18.1%).
- Healing time was shorter with combination therapy (MD = -9.09 days, 95% CI: -11.98 to -6.20, I 2 = 91.2%).
- Combination therapy increased granulation coverage (MD = 7.56%, 95% CI: 6.09-9.03, I 2 = 0.0%) and reduced bacterial positivity (RR = 0.27, 95% CI: 0.18-0.41, I 2 = 0.0%).
- Time from debridement to skin grafting was reduced by 2.82 days (MD = -2.82 days, 95% CI: -3.15 to -2.50, I 2 = 4%).
Why it matters
Chronic refractory wounds can be difficult to heal, and these pooled trial findings suggest that topical oxygen added to NPWT may improve several healing-related outcomes. The results are relevant to evaluating adjunctive wound-care strategies, but the marked heterogeneity in healing time means the size and consistency of that benefit remain uncertain.
What to keep in mind
The pooled estimate for healing time had substantial heterogeneity (I 2 = 91.2%), limiting confidence in the consistency of that outcome across trials.