Growth Promoting Effect of Vacuum Sealing Drainage in the Healing Processes of Diabetic Foot Ulcers

The meta‐analysis aimed to assess and compare diabetic foot wound ulcer management by vacuum sealing drainage. Using dichotomous or contentious random‐ or fixed‐effects models, the outcomes of this meta‐analysis were examined, and the odds ratio (OR) and the mean difference (MD) with 95% confidence intervals (CIs) were computed. Twenty‐three examinations from 2000 to 2023 were enrolled for the present meta‐analysis, including 1928 individuals with diabetic foot ulcers. Vacuum sealing drainage had significantly lower wound healing (OR, 2.35; 95% CI, 1.79–3.08, p < 0.001), lower duration of therapy (MD, −6.19; 95% CI, −10.06 to −2.32, p = 0.002), higher wound size reduction (MD, 4.22; 95% CI, 0.87–7.56, p = 0.01) and lower complication (OR, 0.32; 95% CI, 0.13–0.80, p = 0.01) compared with standard therapy in patients with diabetic foot ulcers. The examined data revealed that vacuum sealing drainage had significantly lower wound healing, duration of therapy and complication rates, as well as higher wound size reduction, compared with standard therapy in patients with diabetic foot ulcers. Yet, attention should be paid to its values since most of the selected examinations had a low sample size.

Section: Resultsmentioning

confidence: 99%

Diabetic foot wound ulcers management by vacuum sealing drainage: A meta‐analysis

Yang,

Zhao,

Yang

et al. 2023

“… 12 In 2019, shine et al analysed through a review of 45 literature on a total of 404 patients with upper extremity trauma defects using VSD, and VSD was significantly superior to conventional adjuvants. 13 The mechanism of VSD to promote tissue regeneration in trauma is not fully understood, and some studies suggest that the mechanical stress between negative pressure closed drainage foam dressing and epidermal cells in trauma can change cell morphology and function, promote intravascular epithelial cell proliferation, early regression of inflammatory factors such as lymphocytes in trauma, active fibroblasts in proliferative phase, opening of microvascular beds and tissue edema subsidence are all beneficial to trauma healing, 14 in addition, the effect of continuous constant negative pressure can increase the blood flow rate, bring the required nutrients to the blood vessels, improve the immunity of the wound surface, increase the tissue perfusion pressure and stimulate granulation tissue growth. 15 Gao YB et al showed that the capillary proliferation rate was significantly higher in the VSD treatment group than in the control group, and VSD greatly increased the growth rate of granulation tissue and accelerated wound healing.…”

Section: Discussionmentioning

confidence: 99%

Application of VSD technique in adults with chronic osteomyelitis of the extremities combined with soft tissue defects

Zhang

Chen

Xiao

et al. 2022

To investigate the clinical application of vacuum sealing drainage (VSD) in chronic osteomyelitis of the extremities combined with soft tissue defects in adults. This study retrospectively included 32 adult patients with clearly diagnosed chronic osteomyelitis of the extremities combined with local soft tissue defects, and the trauma was covered by VSD after debridement, osteotomy, and vancomycin‐laden bone cement filling of the occupancy, and the trauma was covered by selecting a suitable flap transfer repair according to the site and extent of the soft tissue defect after the trauma condition was suitable, and the secondary trauma was taken from the abdominal full‐thickness skin free skin slice graft, according to whether the skin graft area was performed. The skin flap hematoma and infection rate, as well as the skin flap survival rate and implant fixation time were compared and analysed between the two groups. The primary outcome is the implant fixation time, and the secondary outcome is the skin fragment survival rate. In 32 patients, VSD was performed on the bone cement surface to cover the trauma, and 33.2 to 39.8 kPa continuous vacuum sealing drainage was set. The average VSD time duration before soft tissue coverage was 47.87 ± 23.14 days, and the average number of VSD use was 7.18 ± 3.23. The use of VSD before soft tissue coverage did not cause complications such as negative pressure could not be maintained, vacuum sealing drainage was not smooth, skin blistering, trauma. Among the 32 patients, 12 cases of soft tissue coverage were followed by trauma free skin grafting with packing + VSD, and 20 cases were fixed with packing alone, and the duration of continuous packing and fixation of free skin pieces in the VSD group was significantly less than that in the control group (P = .006). The survival rate was significantly higher than that of the control group (P = .019). VSD in adult patients with chronic osteomyelitis of the extremities combined with soft tissue defects can effectively improve the trauma condition, provide the possibility of second‐stage soft tissue coverage, and significantly shorten the preparation time for soft tissue coverage. In addition, when soft tissue coverage trauma is performed, VSD combined with skin graft packing technique can significantly improve the survival rate of skin pieces, shorten the time of skin graft fixation.

“…The difference in healing time of a total of 12 studies [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] (839 patients in total) was analysed. The heterogeneity test of each study yielded P < .00001 and I 2 = 94%, indicating that the included studies were highly heterogeneous.…”

Section: Healing Timementioning

confidence: 99%

“…A relatively clean and humid healing environment is created, promoting liquid exudation and drainage of the wound, accelerating the growth of granulation tissue, and controlling infection. 15 , 16 , 17 However, VSD belongs to physical therapy and does not have biological recovery function for wound healing of patients. In summary, how to effectively treat DFU remains to be solved.…”

Section: Introductionmentioning

confidence: 99%

“…Continuous negative pressure suction is given, thereby the open wound is temporarily closed. A relatively clean and humid healing environment is created, promoting liquid exudation and drainage of the wound, accelerating the growth of granulation tissue, and controlling infection 15‐17 . However, VSD belongs to physical therapy and does not have biological recovery function for wound healing of patients.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A meta‐analysis on the efficacy of vacuum sealing drainage combined with autologous platelet‐rich plasma in the treatment of Grade 2 and Grade 3 diabetic foot ulcers

Yin

et al. 2022

This meta‐analysis aims to systemically evaluate the efficacy of vacuum sealing drainage (VSD) combined with autologous platelet‐rich plasma (PRP) in the treatment of diabetic foot ulcers (DFU). The China HowNet, China Biomedical Literature, VIP periodical resource integration service platform, Wanfang, Embase, Cochrane Central, and PubMed databases were retrieved using the computer. The retrieval period was up to July 2021. Randomised controlled trials on VSD combined with PRP in the treatment of DFU were collected. Those trials that met the inclusion criteria were included for meta‐analysis using RevMan 5.3 software. A total of 13 articles were included. In the trial group, 477 patients with DFU were treated with VSD combined with PRP, while in the control group, 482 patients with DFU were treated with conventional dressings and/or VSD. The meta‐analysis showed that, compared with the control group, VSD combined with PRP has significant advantages in shortening healing time (standardised mean difference [SMD] = −0.87, 95% confidence interval [CI]: −1.07 to −0.67, P < .00001), improving ulcer healing rates (odds ratio = 4.01, 95% CI: 2.95 ~ 5.46, P < .00001), and reducing hospital stays (mean difference = −15.29, 95% CI: −16.05 to −14.54, P < .00001), but the differences in dressing change times (SMD = −1.27, 95% CI: −2.71 to 0.17, P = .08) and hospitalisation expenses (SMD = −0.16, 95% CI: −13.40 to 13.07, P = .98) were not statistically significant. VSD combined with autologous PRP has good curative efficacy in the treatment of DFU and is a better treatment option. However, this treatment is limited in patients with platelet dysfunction, thrombocytopenia, leukaemia, and poor general condition.