Plain language summary Negative pressure wound therapy for treating pressure ulcers Key messages What are pressure ulcers? Pressure ulcers, also known as bedsores, decubitus ulcers, and pressure injuries, are areas of injury to the skin, the tissue that lies underneath, or both. Pressure ulcers can be painful, may become infected, and affect people’s quality of life. People at risk of developing pressure ulcers include those with spinal cord injuries and those who are immobile or who have limited mobility. How are pressure ulcers managed? There is a wide variety of treatment options available for pressure ulcers, such as dressings, reconstructive surgery, redistribution of pressure, electrical stimulation, and negative pressure wound therapy (NPWT). NPWT is a technology that is used widely and is promoted for use on wounds, including pressure ulcers. In NPWT, a machine that exerts carefully controlled suction (negative pressure) is attached to a wound dressing that covers the pressure ulcer. This sucks any wound and tissue fluid away from the treated area into a canister. The researchers tried to discover whether NPWT works well as a treatment for pressure ulcers. What did we want to find out? The aim of this review is to find out whether the use of NPWT is effective in the treatment of pressure ulcers in any care setting. We wanted to assess the benefits (complete wound healing; healing time) and risks (adverse events) of NPWT with alternative treatments or different types of NPWT in the treatment of pressure ulcers. We also cared about several other outcomes including quality of life, wound infection, change in ulcer size and severity, pain, cost, resource use, and wound recurrence. What did we do? We searched the medical literature for published and unpublished robust medical studies (randomised controlled studies) that assessed NPWT for treating pressure ulcers, with no restrictions on language, date of publication, or study setting. We compared and summarised their results, and rated our confidence in the evidence according to research methods, scale, and other factors. What did we find? We found eight studies published between 2002 and 2022 involving a total of 327 participants with pressure ulcers at Category/Stage III or above. Five studies compared NPWT with dressings. Only one study with a total of 12 participants reported usable primary outcome data (complete wound healing; adverse events) and found that there was no evidence of a difference in the number of participants with complete wound healing and adverse events in the NPWT group and the dressing group. Three studies reported that NPWT may reduce the size of pressure ulcers compared with dressing, but the results were not reported clearly and the certainty of evidence was very low. One study with a total of 60 participants compared NPWT combined with Internet‐plus home care compared with standard care. This study reports that NPWT combined with Internet‐plus home care may reduce the surface area of ulcers, pain, and dressing change times compared with standard care, but due to the risk of bias in the study, we downgraded the certainty of evidence to a very low level. One study compared NPWT with a series of topical treatments and one study compared it with what was described only as ‘moist wound healing’, but no useful data were obtained. What are the limitations of the evidence? The current evidence on the efficacy of NPWT in the treatment of pressure ulcers is limited, and most studies were small (median 37 participants), poorly reported, of fairly short or unclear duration, and contained little in the way of useful data. We were not able to draw any conclusions about the benefits or harms of NPWT in treating pressure ulcers based on existing evidence. High‐quality research is still needed to help decision‐makers judge the value of NPWT in the treatment of pressure ulcers. How up‐to‐date is this evidence? This evidence is current to January 2022.
【저자키워드】 Adult, humans, Surgical Wound Infection, pressure ulcer, ulcer, Bandages, Negative-Pressure Wound Therapy, Negative-Pressure Wound Therapy/methods, Pressure Ulcer/therapy,