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Negative pressure wound therapy vs. conventional management in open tibia fractures: Systematic review and meta-analysis
- Source :
- Injury. 50:1764-1772
- Publication Year :
- 2019
- Publisher :
- Elsevier BV, 2019.
-
Abstract
- Severe open tibia fractures are disastrous injuries associated with a high incidence of complications. Negative pressure wound therapy (NPWT) is a novel treatment for open tibia fractures; however, its efficacy remains unclear. This is a systematic review and meta-analysis performed to evaluate the effect of NPWT on decreasing the infection rate, amputation rate, nonunion rate, and flap-related complications in open tibia fractures.The MEDLINE, EMBASE, and Cochrane Library databases were systematically searched. Complications were evaluated in terms of the rates of infection, amputation, nonunion, and flap-related complications.Twelve studies were included. In the meta-analysis, NPWT showed significantly lower soft-tissue infection rate (odds ratio [OR] 0.48, 95% confidence interval [CI] 0.34-0.68, P 0.0001), nonunion rate (OR 0.61, 95% CI 0.39-0.95, P = 0.03), flap necrosis rate (OR 0.37, 95% CI 0.21-0.63, P = 0.0003), and flap revision rate (OR 0.44, 95% CI 0.22-0.89, P = 0.02) than conventional wound management. However, no significant difference was found in osteomyelitis rate (OR 0.54, 95% CI 0.09-3.28, P = 0.50) and amputation rate (OR 0.89, 95% CI 0.36-2.22, P = 0.80) between the 2 groups.Lower rates of soft-tissue infection, nonunion, flap necrosis, and flap revision were observed in the NPWT group than in the conventional dressing group. However, additional high-quality studies are warranted to verify the efficacy of NPWT in the treatment of severe open tibia fractures. We could not make a definitive conclusion about the comparative efficacy of the 2 methods in terms of complications because of insufficient data.
- Subjects :
- medicine.medical_specialty
medicine.medical_treatment
Nonunion
Cochrane Library
Fractures, Open
03 medical and health sciences
0302 clinical medicine
Negative-pressure wound therapy
medicine
Humans
Surgical Wound Infection
Tibia
General Environmental Science
Wound Healing
030222 orthopedics
business.industry
030208 emergency & critical care medicine
Odds ratio
medicine.disease
Bandages
Confidence interval
Surgery
Tibial Fractures
Treatment Outcome
Amputation
Meta-analysis
General Earth and Planetary Sciences
business
Negative-Pressure Wound Therapy
Subjects
Details
- ISSN :
- 00201383
- Volume :
- 50
- Database :
- OpenAIRE
- Journal :
- Injury
- Accession number :
- edsair.doi.dedup.....b5a691d02e922586f664df4fc02ad63d