Negative-pressure therapy versus standard wound care: a meta-analysis of randomized trials

Plast Reconstr Surg. 2011 Nov;128(5):498e-503e. doi: 10.1097/PRS.0b013e31822b675c.


Background: Several randomized controlled trials comparing negative-pressure therapy to standard wound care for chronic wounds have been published. Although these studies suggest a benefit for negative-pressure therapy, the majority of the review articles on the topic conclude that the studies are inconclusive. The authors conducted a quantitative meta-analysis of the effectiveness of negative-pressure therapy for the management of chronic wounds.

Methods: The MEDLINE, EMBASE, and Cochrane databases were searched from 1993 to March of 2010 for randomized controlled trials comparing negative-pressure therapy to standard wound care for chronic wounds. Measures of wound size and time to healing, along with the corresponding p values, were extracted from the randomized controlled trials. Relative change ratios of wound size and ratios of median time to healing were combined using a random effects model for meta-analysis.

Results: Ten trials of negative-pressure therapy versus standard wound care were found. In the negative-pressure therapy group, wound size had decreased significantly more than in the standard wound care group (relative change ratio, 0.77; 95 percent confidence interval, 0.63 to 0.96). Time to healing was significantly shorter in the negative-pressure therapy group in comparison with the standard wound care group (ratio of median time to healing, 0.74; 95 percent confidence interval, 0.70 to 0.78).

Conclusions: This quantitative meta-analysis of randomized trials suggests that negative-pressure therapy appears to be an effective treatment for chronic wounds. An effect of publication bias cannot be ruled out.

Clinical question/level of evidence: Therapeutic, II.

Publication types

  • Comparative Study
  • Meta-Analysis
  • Review

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Bandages
  • Chronic Disease
  • Evaluation Studies as Topic
  • Female
  • Humans
  • Male
  • Negative-Pressure Wound Therapy / methods*
  • Pressure Ulcer / therapy
  • Prognosis
  • Randomized Controlled Trials as Topic
  • Severity of Illness Index
  • Skin Care / methods
  • Surgical Wound Dehiscence / therapy
  • Treatment Outcome
  • Wound Healing / physiology*
  • Wounds and Injuries / diagnosis*
  • Wounds and Injuries / therapy*


  • Anti-Bacterial Agents