A meta-analysis of the management of open tibia fracture wounds with negative pressure wound care compared with traditional wound dressing

Abstract

Mohamed S. Imam*, Lujain Shbeir, Manar Alzahrani, Kadi Yahya Alanazi, Sana Manzari, Norah Ayidh Jabbar Alghamdi, Meaad Hossain Alqorashi, Lojain Saeed Mohammed Alqahtani, Lina Ahmed Alzahrani, Nouf Saleh Ahmed Badawod, Khawla Lafe Fahad Alobaywi, Mohammed Gamal, Mohammed A. Amin, Marina E. Boules, Mohamed E. A. Abdelrahim

Background and Objectives: The drive of the meta-analysis was to appraise and compare the consequence of Negative Pressure Wound Treatment (NPWT) in the management of open tibia fracture wounds compared with Conventional Wound Dressing (CWD).

Methods: The outcomes identified in this meta-analysis were thoroughly examined, and the Odds Ratio (OR) and Mean Difference (MD) were calculated with 95% Confidence Intervals (CIs). These models can be dichotomous, contentious, or based on random or fixed effects. The existing meta-analysis encompassed 18 studies from 2003 to 2022, encompassing 3331 subjects with post-operative infection after open tibia fracture wounds.

Results: NPWT had a significantly lower post-operative infection rate (OR, 0.28; 95% CI, 0.19-0.42, p<0.001), wound coverage rate (OR, 0.09; 95% CI, 0.03-0.22, p<0.001), wound healing rate (OR, 0.05; 95% CI, 0.02-0.14, p<0.001), and patient hospital stay rate (OR, 0.06; 95% CI, 0.02-0.17, p<0.001) compared to CWD in open tibia fracture wound subjects. However, no significant difference was found between NPWT and CWD in flap surgery (OR, 1.18; 95% CI, 0.78-1.77, p=0.43), and non-union rate (OR, 1.00; 95% CI, 0.71-1.40, p=0.99) in open tibia fracture wound subjects.

Conclusions: The examined data revealed that NPWT had a significantly lower post-operative infection rate, wound coverage rate, wound healing rate, and patient hospital stay rate however, no significant difference was found in flap surgery, and non-union rate compared to CWD in open tibia fractures wound subjects. Nevertheless, their values should be taken into account as several research only encompassed a minor number of participants and some comparisons involved low number of studies.