Adv Wound Care (New Rochelle). 2022 May 20. doi: 10.1089/wound.2022.0041. Online ahead of print.
ABSTRACT
OBJECTIVE: To conduct a systematic review and meta-analysis of recently published randomized controlled trials (RCTs) that employed the use of topical oxygen therapy as an adjunct therapy in the treatment of Wagner 1 and 2 diabetic foot ulcers Approach: Following a literature search of eligible studies from 2010 onward, 4 RCTs were included. Studies were analyzed for patient and wound characteristics, outcomes, risk of bias, and quality of the evidence assessed using the GRADE methodology. A random effects meta-analysis for complete wound healing was carried out due to statistical heterogeneity of included studies.
RESULTS: Risk of bias judgment (Rob2 analysis) resulted in 1 low-risk trial and 3 trials with some risk. One study was determined to be the origin of the statistical heterogeneity. Pooled results showed statistical significance with a risk ratio (RR) of 1.59 (95% CI: 1.07-2.37); p = .021. Sensitivity analysis, based on imputed values for missing outcomes, demonstrated that both the RR and 95% confidence intervals changed little. The GRADE ratings for each domain were: (a) risk of bias: moderate (3); (b) imprecision: moderate (2), high (1); (c) inconsistency: low (2), high (1); (d) indirectness: moderate (2), high (1); and (e) publication bias: moderate (1), high (2). Overall, the evidence was moderate.
INNOVATION: Our study shows that topical oxygen therapy is a viable diabetic foot ulcer therapy.
CONCLUSIONS: This data supports the use of topical oxygen therapy for the treatment of chronic Wagner 1 or 2 diabetic foot ulcers in the absence of infection and ischemia.
PMID:35593010 | DOI:10.1089/wound.2022.0041
