Adjunctive hyperbaric oxygen therapy and negative pressure wound therapy for hard-to-heal wounds: a systematic review and meta-analysis
Bibliographic record
Abstract
OBJECTIVE: Negative pressure wound therapy (NPWT) and hyperbaric oxygen therapy (HBOT) have been widely used in the treatment of hard-to-heal (chronic) wounds, but there is still a lack of sufficient evidence for their combined use for the treatment of hard-to-heal wounds. This systematic review aimed to identify the clinical efficacy and safety of adding adjunctive HBOT to NPWT for hard-to-heal wounds. METHOD: Embase, PubMed, Cochrane Library, Web of Science, China National Knowledge Infrastructure and Wanfang were searched from the establishment of the database to March 2022. The literature was screened according to the inclusion criteria and exclusion criteria. We assessed the quality of each included study with the Cochrane Collaboration Risk of Bias tool and Newcastle-Ottawa Scale. A meta-analysis was performed using R programming software version 4.1.0 (R Project for Statistical Computing, US). The PRISMA 2020 guidelines were used to report data from systematic reviews and meta-analysis. RESULTS: A total of 15 studies were identified, including nine randomised clinical controlled trials and six retrospective studies. Meta-analysis results showed that NPWT combined with HBOT had better outcomes compared with the NPWT alone with regards to: wound healing rate (odds ratio (OR)=6.77; 95% confidence interval (Cl): 3.53-12.98; p<0.0001); bacterial positive rate of wound (OR=0.16; 95% CI: 0.05-0.55; p=0.0037); wound healing time (mean difference (MD)= -3.86; 95% Cl: -5.18 - -2.53; p<0.0001); wound area (standardised mean difference (SMD)=1.50; 95% Cl: 0.35-2.65; p=0.0104); hospitalisation time (MD= -3.14; 95% Cl: -4.93 - -1.36; p=0.005); and hospitalisation cost (OR= -202.64; 95% Cl: -404.53 - -0.75; p=0.0492). There was no significant difference in pain score (MD= -0.43; 95% Cl: -1.15-0.30; p=0.25). CONCLUSION: The findings of this study demonstrated that adjunctive HBOT with NPWT is safe and effective in the treatment of hard-to-heal wounds. However, these findings should be interpreted with great caution given the limitations of the studies included.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.012 | 0.027 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.023 | 0.041 |
| Bibliometrics | 0.009 | 0.008 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".