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Negative pressure wound therapy for treating foot wounds in people with diabetes mellitus

  1. Jo C Dumville1,*,
  2. Robert J Hinchliffe2,
  3. Nicky Cullum3,
  4. Fran Game4,
  5. Nikki Stubbs5,
  6. Michael Sweeting6,
  7. Frank Peinemann7

Editorial Group: Cochrane Wounds Group

Published Online: 17 OCT 2013

Assessed as up-to-date: 30 JUL 2013

DOI: 10.1002/14651858.CD010318.pub2


How to Cite

Dumville JC, Hinchliffe RJ, Cullum N, Game F, Stubbs N, Sweeting M, Peinemann F. Negative pressure wound therapy for treating foot wounds in people with diabetes mellitus. Cochrane Database of Systematic Reviews 2013, Issue 10. Art. No.: CD010318. DOI: 10.1002/14651858.CD010318.pub2.

Author Information

  1. 1

    University of Manchester, Department of Nursing, Midwifery and Social Work, Manchester, UK

  2. 2

    St George's Healthcare NHS Trust, St George's Vascular Institute, London, UK

  3. 3

    University of Manchester, School of Nursing, Midwifery and Social Work, Manchester, UK

  4. 4

    Derby Hospitals NHS Foundation Trust, Department of Diabetes and Endocrinology, Derby, UK

  5. 5

    Leeds Community Healthcare NHS Trust, St Mary's Hospital, Wound Prevention and Management Service, Leeds, UK

  6. 6

    Institute of Public Health, MRC Biostatistics Unit, Cambridge, UK

  7. 7

    Children's Hospital, University of Cologne, Cologne, NW, Germany

*Jo C Dumville, Department of Nursing, Midwifery and Social Work, University of Manchester, Manchester, M13 9PL, UK. jo.dumville@manchester.ac.uk.

Publication History

  1. Publication Status: New
  2. Published Online: 17 OCT 2013

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References

References to studies included in this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to studies awaiting assessment
  4. References to ongoing studies
  5. Additional references
Armstrong 2005 {published data only}
  • Apelqvist J, Armstrong DG, Lavery LA, Boulton AJ. Resource utilization and economic costs of care based on a randomized trial of vacuum-assisted closure therapy in the treatment of diabetic foot wounds. American Journal of Surgery  2008;195(6):782-8.
  • Apelqvist J, Armstrong DG, Lavery LA, Boulton AJM. Diabetic foot ulcer and VAC resource utilization and economic cost based on a randomized trial. 20th Annual Symposium on Advanced Wounds Care and the Wound Healing Society Meeting; 2007, 28 April -1 May. Tampa, FL, 2007.
  • Armstrong DG, Lavery LA. Negative pressure wound therapy after partial diabetic foot amputation: a multicentre, randomised controlled trial. Lancet 2005;366(9498):1704-10.
  • Armstrong DG, Lavery LA, Boulton AJ. Negative pressure wound therapy via vacuum-assisted closure following partial foot amputation: What is the role of wound chronicity?. International Wound Journal  2007;4(1):79-86.
  • Armstrong DG, Lavery LA, Frykberg RG, Andros G, Attinger CE, Boulton AJM. VAC therapy appears to heal complex DFU. 2nd World Union of Wound Healing Societies Meeting; 2004, 8-13 July; Paris. Paris, 2004.
  • Driver V, Andersen C, Taneja C, Oster G. Evaluation of health-care utilization and costs for hospitalizations and surgical procedures in patients with diabetic foot ulcers treated with negative pressure wound therapy using open cell foam versus advanced moist wound therapy. 3rd Congress of the World Union of Wound Healing Societies Meeting; 2008, 4-8 June; Toronto. Toronto, 2008:Abstract no. OR035.
Blume 2008 {published data only}
  • Blume PA, Sumpio BE. Interim results of a randomized, controlled multicenter trial of vacuum-assisted closure therapy* in the treatment and blinded evaluation of diabetic foot ulcers. 20th Annual Symposium on Advanced Wounds Care and the Wound Healing Society Meeting; 2007, 28 April -1 May. Tampa, FL, 2007.
  • Blume PA, Walters J, Payne W, Ayala J, Lantis J. Comparison of negative pressure wound therapy using Vacuum-assisted closure with advanced moist wound therapy in the treatment of diabetic foot ulcers: a multicenter randomized controlled trial. Diabetes Care  2008;31(4):631-6.
Karatepe 2011 {published data only}
  • Karatepe O, Eken I, Acet E, Unal O, Mert M, Koc B, et al. Vacuum assisted closure improves the quality of life in patients with diabetic foot. Acta Chirurgica Belgica 2011;111(5):298-302.
Mody 2008 {published data only}
  • Mody GN, Nirmal IA, Duraisamy S, Perakath B. A blinded, prospective, randomized controlled trial of topical negative pressure wound closure in India. Ostomy/Wound Management  2008;54(12):36-46.
Novinščak 2010 {published data only}
  • Novinscak T, Zvorc M,   Trojko S, Jozinovic E, Filipovic M, Grudic R. Comparison of cost-benefit of the three methods of diabetic ulcer treatment: dry, moist and negative pressure [Usporedba troska i koristi (cost-benefit)triju nacina lijecenja dijabetickog vrijeda: Suhim prevojem, vlaznim prevojem i negativnim tlakom LA: Cro]. Acta Medica Croatica 2010;64(Suppl 1):113-5.

References to studies excluded from this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to studies awaiting assessment
  4. References to ongoing studies
  5. Additional references
Armstrong 2012 {published data only}
Braakenburg 2005 {published data only}
  • Braakenburg A, Obdeijn MC, Feitz R, van Rooij IA, van Griethuysen AJ, Klinkenbijl JH. The clinical efficacy and cost effectiveness of the vacuum-assisted closure technique in the management of acute and chronic wounds: a randomized controlled trial. Plastic and Reconstructive Surgery  2006;118(2):390-7.
Chong {published data only}
  • Chong SJ, Kwan TM, Weihao L, Joang KS, Rick SC. Maintenance of negative-pressure wound therapy while undergoing hyperbaric oxygen therapy. Diving and hyperbaric medicine: the journal of the South Pacific Underwater Medicine Society  2011;41(3):147-50.
Eginton 2003 {published data only}
  • Eginton MT, Brown KR, Seabrook GR, Towne JB, Cambria RA. A prospective randomized evaluation of negative-pressure wound dressings for diabetic foot wounds. Annals of Vascular Surgery 2003;17(6):645-9.
Etoz 2007 {published data only}
  • Etoz A, Ozgenel Y, Ozcan M. The use of negative pressure wound therapy on diabetic foot ulcers: a preliminary controlled trial. Wounds: A Compendium of Clinical Research and Practice 2004;16(8):264-9.
Foo 2004 {published data only}
  • Foo LSS, Chua BSY, Chia GT, Tan SB, Howe TS. Vacuum assisted closure vs moist gauze dressing in post-operative diabetic foot wounds: Early results from a randomised controlled trial. 2nd World Union of Wound Healing Societies Meeting; 2004 ,8-13 July; Paris. Paris, 2004.
Maggio 2010 {published data only}
  • Maggio G, Armenio A, Pascone M. Bio-engineered tissue and VAC therapy: A new method for the treatment of the wide soft tissue defects in the diabetic foot. European Journal of Clinical Investigation 2010;40:87.
McCallon 2000 {published data only}
  • McCallon SK, Knight CA, Valiulus JP, Cunningham MW, McCulloch JM, Farinas LP. Vacuum-assisted closure versus saline-moistened gauze in the healing of postoperative diabetic foot wounds. Ostomy/Wound Management 2000;46(8):28-34.
Moues 2004 {published data only}
  • Moues CM, Vos MC, van den Bemd GJ, Stijnen T, Hovius SE. Bacterial load in relation to vacuum-assisted closure wound therapy: a prospective randomized trial. Wound Repair and Regeneration 2004;12(1):11-7.
  • Moues CM, van den Bemd GJ, Heule F, Hovius SE. Comparing conventional gauze therapy to vacuum-assisted closure wound therapy: a prospective randomised trial. Journal of Plastic, Reconstructive and Aesthetic Surgery 2007;60(6):672-81.
  • Mouës CM, van den Bemd GJ, Meerding WJ, Hovius SE. An economic evaluation of the use of TNP on full-thickness wounds. Journal of Wound Care 2005;14(5):224-7.
Perez 2010 {published data only}
  • Perez D, Bramkamp M, Exe C, von Ruden C, Ziegler A. Modern wound care for the poor: a randomized clinical trial comparing the vacuum system with conventional saline-soaked gauze dressings. American Journal of Surgery  2010;199(1):14-20.
Rahmanian-Schwarz 2012 {published data only}
  • Rahmanian-Schwarz A, Willkomm LM, Gonser P, Hirt B, Schaller HE. A novel option in negative pressure wound therapy (NPWT) for chronic and acute wound care. Burns 2012;38(4):573-7.
Riaz 2010 {published data only}
  • Riaz MU, Khan M-UR, Akbar A. Comparison of vacuum assisted closure versus normal saline dressing in healing diabetic wounds. Pakistan Journal of Medical and Health Sciences 2010;4(4):308-12.
Sepulveda 2009 {published data only}
  • Sepulveda G, Espindola M, Maureira M, Sepulveda E, Fernandez JI, Oliva C, et al. Negative-pressure wound therapy versus standard wound dressing in the treatment of diabetic foot amputation. A randomised controlled trial. Cirugia Espanola 2009;86(3):171-7.

References to studies awaiting assessment

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to studies awaiting assessment
  4. References to ongoing studies
  5. Additional references
Sun 2007 {published data only}
  • Sun JW, Sun JH, Zhang CC. Vacuum assisted closure technique for repairing diabetic foot ulcers: Analysis of variance by using a randomized and double-stage crossover design. Journal of Clinical Rehabilitative Tissue Engineering Research 2007;11(14):8908-11.
Tuncel 2013 {published data only}

References to ongoing studies

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to studies awaiting assessment
  4. References to ongoing studies
  5. Additional references
ISRCTN34166832 {published data only}
  • ISRCTN34166832. 100 Patient study of PICO v Standard care in chronic / sub-acute wounds. http://www.controlled-trials.com/ISRCTN34166832 (accessed 5 October 2013).
ISRCTN90301130 {published data only}
  • ISRCTN90301130. Treatment of Diabetic Foot Wounds by Vacuum-Assisted Closure (VAC®): A multicentre, randomised controlled trial. http://www.controlled-trials.com/ISRCTN90301130 (accessed 5 October 2013).

Additional references

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to studies awaiting assessment
  4. References to ongoing studies
  5. Additional references
Abbott 2002
Apelqvist 2000a
  • Apelqvist J, Bakker K, Van Houtum WH, Nabuurs-Franssen MH, Schaper NC. International consensus and practical guidelines on the management and the prevention of the diabetic foot. International Working Group on the Diabetic Foot. Diabetes Metabolism Research and Reviews 2000;16(Suppl 1):S84-92.
Apelqvist 2000b
  • Apelqvist J, Larsson J. What is the most effective way to reduce incidence of amputation in the diabetic foot?. Diabetes Metabolism Research and Reviews 2000;16(Suppl 1):S75-83.
Centers for Disease Control and Prevention 2011
  • Centers for Disease Control and Prevention. 2011 National Diabetes Fact Sheet. http://www.cdc.gov/diabetes/pubs/estimates11.htm 2011; Vol. Access Dec 2012.
Deeks 2002
  • Deeks JJ. Issues in the selection of a summary statistic for meta-analysis of clinical trials with binary outcomes. Statistics in Medicine 2002;21(1):575-600.
Department of Health 2010
  • Department of Health. About diabetes [Diabetes in the UK 2010:Key statistics on diabetes]. http://www.diabetes.org.uk/Documents/Reports/Diabetes_in_the_UK_2010.pdf 2010; Vol. Access Jan 2013.
Department of Health and Human Services 2009
  • Department of Health and Human Services, Office of Inspector General. Comparison of prices for negative pressure wound therapy pumps. https://oig.hhs.gov/oei/reports/oei-02-07-00660.pdf. OEI-02-07-00660 2009; Vol. Access Dec 2012.
Diabetes UK 2011
  • Diabetes UK. Diabetes Prevalence 2011. http://www.diabetes.org.uk/Professionals/Publications-reports-and-resources/Reports-statistics-and-case-studies/Reports/Diabetes-prevalence-2011-Oct-2011/ 2011; Vol. Access Dec 2012.
Dorresteijn 2010
Dumville 2011a
  • Dumville JC, O'Meara S, Deshpande S, Speak K. Hydrogel dressings for healing diabetic foot ulcers. Cochrane Database of Systematic Reviews 2011, Issue 9. [DOI: 10.1002/14651858.CD009101.pub2]
Dumville 2011b
  • Dumville JC, Deshpande S, O'Meara S, Speak K. Foam dressings for healing diabetic foot ulcers. Cochrane Database of Systematic Reviews 2011, Issue 9. [DOI: 10.1002/14651858.CD009111.pub2]
Dumville 2012a
  • Dumville JC, Deshpande S, O'Meara S, Speak K. Hydrocolloid dressings for healing diabetic foot ulcers. Cochrane Database of Systematic Reviews 2012, Issue 2. [DOI: 10.1002/14651858.CD009099.pub2]
Dumville 2012b
  • Dumville JC, O'Meara S, Deshpande S, Speak K. Alginate dressings for healing diabetic foot ulcers. Cochrane Database of Systematic Reviews 2012, Issue 2. [DOI: 10.1002/14651858.CD009110.pub2]
Dumville 2012c
  • Dumville JC, Soares MO, O'Meara S, Cullum N. Systematic review and mixed treatment comparison: dressings to heal diabetic foot ulcers. Diabetologia 2012;55(7):1902-10.
Eneroth 2008
FDA 2011
  • US Food, Drug Administration. FDA Safety Communication: Update on serious complications associated with negative pressure wound therapy systems. http://www.fda.gov/MedicalDevices/Safety/AlertsandNotices/ucm244211.htm 2011; Vol. Access Nov 2012.
Game 2012
Higgins 2003
Higgins 2011
  • Higgins JPT, Altman DG, on behalf of the Cochrane Statistical Methods Group and the Cochrane Bias Methods Group (Editors). Chapter 8:  Assessing risk of bias in included studies. In: Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from www.cochrane-handbook.org.
Holman 2012
Ince 2008
  • Ince P, Abbas ZG, Lutale JK, Basit A, Ali SM, Chohan F, et al. Use of the SINBAD classification system and score in comparing outcome of foot ulcer management on three continents. Diabetes Care 2008;31(5):964-7.
Karthikesalingam 2010
KCI 2012a
  • KCI. Science behind wound therapy. http://www.kci1.com/KCI1/sciencebehindwoundtherapy (accessed 11th May 2012).
KCI 2012b
  • KCI. VAC therapy system clinical guidelines. http://www.kci1.com/KCI1/vactherapyformsandbrochures (acessed 11th May 2012).
Kerr 2012
  • Kerr M. Foot care for people with diabetes: the economic case for change. Factsheet No. 37 2012 March; Vol. http://www.diabetes.org.uk/upload/News/Factsheet%20Footcare%20for%20people%20with%20diabetes.pdf.
Kumar 1994
Lebrun 2010
Lefebvre 2011
  • Lefebvre C, Manheimer E, Glanville J, on behalf of the Cochrane Information Retrieval Methods Group. Chapter 6: Searching for studies. In: Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from www.cochrane-handbook.org.
Liberati 2009
  • Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLoS Medicine 2009;6(7):e1000100.
Margolis 1999
Margolis 2011
  • Margolis D, Malay DS, Hoffstad OJ, Leonard CE, MaCurdy T, Lopez de Nava K, et al. Prevalence of diabetes, diabetic foot ulcer, and lower extremity amputation among Medicare beneficiaries, 2006 to 2008. Diabetic foot ulcers. Data Points #1 (prepared by the University of Pennsylvania DEcIDE Center, under Contract No. HHSA29020050041I). Agency for Healthcare Research and Quality. AHRQ Publication No. 10(11)-EHC009-EF. 2011.
Medical Advisory Secretariat 2006
  • Medical Advisory Secretariat. Negative pressure wound therapy: an evidence-based analysis. Negative pressure wound therapy - Ontario Health Technology Assessment Series 2006 2006; Vol. 6, issue 14:1-38.
Morris 1998
  • Morris AD, McAlpine R, Steinke D, Boyle DI, Ebrahim AR, Vasudev N, et al. Diabetes and lower limb amputations in the community. A retrospective cohort study. DARTS/MEMO Collaboration. Diabetes Audit and Research in Tayside Scotland/Medicines Monitoring Unit. Diabetes Care 1998;21(5):738-43.
Nabuurs-Franssen 2005
  • Nabuurs-Franssen MH, Huijberts MS, Nieuwenhuijzen Kruseman AC, Willems J, Schaper NC. Health-related quality of life of diabetic foot ulcer patients and their caregivers. Diabetologia 2005;48(9):1906-10.
NICE 2011
  • National Institute for Health and Clinical Excellence. Diabetic foot problems - inpatient management: pre-publication check. http://www.nice.org.uk/guidance/index.jsp?action=folder&o=52418 2011.
Noble-Bell 2008
Oyibo 2001
  • Oyibo SO, Jude EB, Tarawneh I, Nguyen HC, Harkless LB, Boulton AJ. A comparison of two diabetic foot ulcer classification systems: the Wagner and the University of Texas wound classification systems. Diabetes Care 2001;24(1):84-8.
Parmar 1998
Pecoraro 1990
Peinemann 2008
  • Peinemann F, McGauran N, Sauerland S, Lange S. Negative pressure wound therapy: potential publication bias caused by lack of access to unpublished study results data. BMC Medical Research Methodology 2008;8:4.
Pound 2005
Public Health Agency of Canada 2011
  • Public Health Agency of Canada. Diabetes in Canada: facts and figures from a public health perspective. http://www.phac-aspc.gc.ca/cd-mc/publications/diabetes-diabete/facts-figures-faits-chiffres-2011/highlights-saillants-eng.php 2011.
Reiber 1996
  • Reiber G. The epidemiology of diabetic foot problems. Diabetic Medicine 1996;13S:S6-11.
Reiber 1999
  • Reiber GE, Vileikyte L, Boyko EJ, del Aguila M, Smith DG, Lavery LA, et al. Causal pathways for incident lower extremity ulcers in patients with diabetes from two settings. Diabetes Care 1999;22(1):157-62.
RevMan 2011 [Computer program]
  • The Nordic Cochrane Centre, The Cochrane Collaboration. Review Manager (RevMan). Version 5.1. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2011.
Ribu 2006
  • Ribu L, Hanestad BR, Moum T, Birkeland K, Rustoen T. A comparison of the health-related quality of life in patients with diabetic foot ulcers, with a diabetes group and a non diabetes group from the general population. Quality of Life Research 2007;16(2):179-89.
Schaper 2004
Schunemann 2011a
  • Schünemann HJ, Oxman AD, Higgins JPT, Vist GE, Glasziou P, Guyatt GH. Chapter 11: Presenting results and ‘Summary of findings' tables. In: Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from www.cochrane-handbook.org.
Schunemann 2011b
  • Schünemann HJ, Oxman AD, Vist GE, Higgins JPT, Deeks JJ, Glasziou P, Guyatt GH. Chapter 12: Interpreting results and drawing conclusions. In: Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from www.cochrane-handbook.org.
Shaw 2010
SIGN 2012
  • Scottish Intercollegiate Guidelines Network (SIGN). Search filters. http://www.sign.ac.uk/methodology/filters.html#random Vol. Access Dec 2012.
Singh 2005
Steed 2006
Tennvall 2000
  • Tennvall GR, Apelqvist J. Health related quality of life in patients with diabetes mellitus and foot ulcers. Journal of Diabetes and its Complications 2000;14(5):235-41.
Ubbink 2008a
Ubbink 2008b
Van Gils 1999
  • Van Gils C, Wheeler LA, Mellsrom M, Brinton EA, Mason S, Wheeler CG. Amputation prevention by vascular surgery and podiatry collaboration in high risk diabetic and non-diabetic patients - the operation desert foot experience. Diabetes Care 1999;22(5):678-83.
Wagner 1981
  • Wagner FW. The dysvascular foot: a system of diagnosis and treatment. Foot and Ankle 1981;2(2):64-122.
Wrobel 2001
  • Wrobel JS, Mayfield JA, Reiber GE. Geographic variation of lower limb extremity major amputation in individuals with and without diabetes in the Medicare population. Diabetes Care 2001;24(5):860-4.