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We identified 48 eligible studies of generally low quality with evaluable data for 4315 patients and 30 eligible studies with missing data for at least 1386 patients. Due to potential publication bias (proportion of inaccessible data, 24%), we downgraded our conclusions. A meta-analysis of all wound healing data showed a significant effect in favour of NPWT (OR 1.56, 95% CI 1.15 to 2.13, p = 0.008). As further analyses of different definitions of wound closure did not contradict that analysis, we inferred an indication of a greater benefit of NPWT. A meta-analysis of hospital stay (in days) showed a significant difference in favour of NPWT (MD − 4.78, 95% CI − 7.79 to − 1.76, p = 0.005). As further analyses of different definitions of hospital stay/readmission did not contradict that analysis, we inferred an indication of a greater benefit of NPWT. There was neither proof (nor indication nor hint) of greater benefit or harm of NPWT for other patient-relevant outcomes such as mortality and adverse events.
我們共納入 48 項符合條件但整體品質偏低的研究(含 4,315 名患者可評估數據),以及 30 項符合條件但數據缺失的研究(至少涉及 1,386 名患者)。由於潛在發表偏誤(無法取得數據比例達 24%),我們降低了結論的可信度。所有傷口癒合數據的統合分析顯示,負壓傷口治療(NPWT)具有顯著優勢(勝算比 1.56,95%信賴區間 1.15 至 2.13,p=0.008)。由於不同傷口閉合定義的進一步分析並未與該結果相矛盾,我們推斷 NPWT 可能帶來更大效益。住院天數的統合分析顯示 NPWT 組顯著縮短(平均差-4.78 天,95%信賴區間-7.79 至-1.76,p=0.005)。針對住院/再住院不同定義的後續分析亦支持此結論,故推測 NPWT 在此方面可能更具優勢。至於其他患者重要預後指標(如死亡率與不良事件),既無證據也無跡象顯示 NPWT 會帶來更大效益或危害。