Negative pressure wound therapy to treat pressure ulcers

key message

What is a pressure ulcer?

Pressure ulcers, also called bedsores, bedsores, or bedsores, are areas of damage to the skin, underlying tissue, or both. Pressure ulcers are painful, can become infected, and affect a person’s quality of life. People at risk of developing pressure ulcers include those with spinal cord injuries, those who are immobile, or have limited mobility.

How are pressure ulcers managed?

There are many treatment options for pressure ulcers, including bandages, reconstructive surgery, pressure redistribution, electrical stimulation, and negative pressure wound therapy (NPWT). NPWT is a widely used technique and is encouraged for use on wounds such as pressure ulcers. In NPWT, a carefully controlled suction (negative pressure) machine is attached to the wound dressing covering the pressure ulcer. This draws wound and tissue fluid from the treatment area into the canister. Researchers sought to discover whether NPWT would be effective in treating pressure ulcers.

what did we want to know?

The purpose of this review is to investigate whether the use of NPWT is effective in treating pressure ulcers in any healthcare setting. We wanted to assess the benefits (complete wound healing, healing time) and risks (adverse events) of his NPWT with alternative treatments or different types of his NPWT in the treatment of pressure ulcers. We also considered several other outcomes, including quality of life, wound infection, changes in ulcer size and severity, pain, costs, resource use, and wound recurrence.

what did we do

We searched the medical literature for robust published and unpublished medical studies (randomised controlled studies) evaluating NPWT for the treatment of pressure ulcers, without restrictions on language, publication date, or study setting. We compared and summarized the results and assessed the confidence in the evidence according to study method, size, and other factors.

what did we find?

We found eight studies published between 2002 and 2022 with a total of 327 participants with category/stage III or higher pressure ulcers. Five studies compared NPWT with bandages. Only one study with a total of 12 participants reported useful primary outcome data (complete wound healing, adverse events), with NPWT and NPWT groups showing complete wound healing and adverse events. We found no evidence of a difference in the number of participants who exhibited dressing group. Three studies reported that NPWT may reduce pressure ulcer size compared to dressings, but the results were not clearly reported and the certainty of the evidence was very low. One study with a total of 60 participants compared NPWT plus internet and home care to standard care. This study reported that combining NPWT with the internet and home care may reduce ulcer surface area, pain, and time to change dressings compared to standard care, but the study is biased. We downgraded the certainty of the evidence to 1 due to the risk of very low level. One study compared NPWT to a range of topical treatments, and another compared NPWT to what was described only as ‘wet wound healing’, but no useful data were obtained.

What are the limits of evidence?

Current evidence for the effectiveness of NPWT in treating pressure ulcers is limited, with most studies small (median 37 participants), poorly reported, fairly short or unclear in duration, and few useful data. is rarely included. Based on the existing evidence, no conclusions can be drawn about the benefits or harms of NPWT in treating pressure ulcers. High-quality research is still needed for decision makers to determine the value of her NPWT in treating pressure ulcers.

How current is this evidence?

This evidence is current as of January 2022.