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Revisión sistemática de los estudios sobre eficacia de terapias con presión negativa en heridas complejas del pie diabético

  • Luis Quecedo
  • Juan del Llano
Artículo de Investigación Original
  • 56 Downloads

Resumen

Objetivo

Evaluación de la eficacia y seguridad de la terapia con dispositivos de presión negativa comparada con las terapias convencionales de las heridas complejas del pie diabético.

Diseño

Revisión sistemática de la literatura.

Fuentes de datos

Embase.com, Medline, Cochrane Library y bases de datos de Agencias de Evaluación de Tecnologías Sanitarias, años 2000–2011.

Selección de estudios

Ensayos clínicos aleatorizados en pacientes adultos con úlceras complejas, heridas postoperatorias o post amputación del pie.

Extracción de datos

Se analizan la tasa de reepitelización a los 112 días, tiempo de curación, complicaciones infecciosas, amputaciones y evaluación de costes.

Resultados

Siete trabajos seleccionados (539 pacientes). Cinco estudios en pacientes con heridas post intervención quirúrgica y post amputación y 2 estudios en pacientes con úlceras del pie diabético. La calidad de los ensayos clínicos valorada mediante escala de Jaddad es 2–3/5. La Taxonomía SORT se utilizó para establecer el grado de recomendación.

Conclusiones

Las evidencias apoyan la eficacia y seguridad de la terapia con presión negativa en las heridas complicadas del pie diabético. Se podría emitir una recomendación tipo B para su utilización dado el perfil de seguridad, los costes y la consistencia de los resultados, a pesar del bajo nivel de calidad de evidencia.

Palabras clave

Pie diabético Terapia con presión negativa Diabetes complicaciones 

Abstract

Objective

Evaluation of the efficacy and safety of negative pressure wound therapy compared with conventional treatments of complex wounds in the feet of diabetic patients.

Design

Systematic database review.

Sources of data

Embase.com, Medline, Cochrane Library y databases from health technology evaluation agencies from the years 2000–2011.

Selection of studies

Randomized clinical trials in adult patients with complex ulcers, post-operative wounds or post foot amputation.

Data extraction

The rate of reepithelization at 112, healing time, infectious complications, amputation will be analyzed and costs will be evaluated.

Results

7 works selected (539 pacients). 5 studies with patients with post-operative and post amputation wounds and 2 studies with patients with diabetic foot ulcers.The methodological quality as measured by the Jaddad scale is 2–3/5. SORT taxonomy were used to label the strength of recommendation.

Conclusions

The evidence supports the effectiveness and safety of negative pressure wound therapy in complex foot wounds in diabetic patients. It could be possible to make a type B recommendation for its use given the safety profile and costs and consistency of the results, in spite of the low quality grade of evidence.

Keywords

Diabetic foot Negative pressure wound therapy Diabetes complications negative-pressure wound Vacuum assisted closure Diabetic ulcers 

Notes

Financiación y conflicto de intereses

Patrocinio no condicionado de KCI Clinic Spain, S.L.

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Copyright information

© Springer International Publishing Switzerland 2013

Authors and Affiliations

  1. 1.Fundación Gaspar CasalMadridEspaña

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