Jiang ZY, Yu XT, Liao XC, Liu MZ, Fu ZH, Min DH, Guo GH, et al.
Burns : journal of the International Society for Burn Injuries. Date of publication 2021 Jun 1;volume 47(4):747-755.
1. Burns. 2021 Jun;47(4):747-755. doi: 10.1016/j.burns.2021.02.012. Epub 2021 Feb
23.
Negative-pressure wound therapy in skin grafts: A systematic review and
meta-analysis of randomized controlled trials.
Jiang ZY(1), Yu XT(1), Liao XC(1), Liu MZ(1), Fu ZH(1), Min DH(1), Guo GH(2).
Author information:
(1)The Department of Burn, The First Affiliated Hospital of Nanchang University,
No. 17 Yong Wai Street, Nanchang 330006, Jiangxi, PR China.
(2)The Department of Burn, The First Affiliated Hospital of Nanchang University,
No. 17 Yong Wai Street, Nanchang 330006, Jiangxi, PR China. Electronic address:
guoghtg@sina.com.
INTRODUCTION: Although skin grafts are widely used in reconstruction of large
skin defect and complex wounds, many factors lead to suboptimal graft take.
Negative-pressure wound therapy (NPWT) reportedly increases the graft take rates
when added to skin grafting, but a summary analysis of the data of randomized
controlled trials has yet to be performed. We conducted this systematic review
and meta-analysis of randomized controlled trials to compare the effectiveness
and safety of NPWT and non-NPWT for patients with skin grafts.
METHODS: We searched PubMed, Embase, Cochrane Library, and CNKI for relevant
trials based on predetermined eligibility criteria from database establishment
to February 2020. Two reviewers screened citations and extracted data
independently. The quality of the included studies was evaluated according to
the Cochrane Handbook, whereas statistical heterogeneity was assessed using
chi-square tests and I2 statistics. Review Manager 5.3 was used for statistical
analysis.
RESULTS: Ten randomized controlled trials with 488 patients who underwent NPWT
or non-NPWT were included. Compared with non-NPWT, NPWT yielded an improved the
percentage of graft take, a reduction in days from grafting to discharge, with
lower relative risk of re-operation, and no increased relative risk of adverse
event. Further, the subgroup analysis showed an improved the percentage of graft
take in negative pressure of 80 mmHg, and no improved the percentage of graft
take in negative pressure of 125 mmHg.
CONCLUSION: NPWT is more effective than non-NPWT for the integration of skin
grafts, and the negative pressure of 80 mmHg can be recommended. Data on adverse
events and negative pressure are, however, limited. A better understanding of
complications after NPWT and the ideal negative pressure for the integration of
skin grafts is imperative.
Copyright © 2021 Elsevier Ltd and ISBI. All rights reserved.
DOI: 10.1016/j.burns.2021.02.012
PMID: 33814213 [Indexed for MEDLINE]
