Table 1.
Characteristics of studies included in the network meta-analysis.
| Author,published year and country | Groups (n) | Study period (weeks) | Mean age (years) | Male gender (n) | Wound duration (weeks) | Wound area (cm2) | Primary outcomes |
|---|---|---|---|---|---|---|---|
| Driver,2017,UAS (33) | SOC(61)/TOT(61) | 12 | 58.8 ± 9.4/58.6 ± 12.31 | 47/43 | 14.9 ± 12.5/17.7 ± 12.8 | 2.3 ± 1.7/2.0 ± 1.7 | Complete wound healing |
| Frykberg,2020,UK (34) |
SOC(36)/TOT(37) | 12 | 61.9 ± 9.5/64.6 ± 10.3 | 31/32 | 24.9 ± 13.4/22.9 ± 13.7 | 3.22 ± 2.54/3.02 ± 2.66 | Complete wound healing |
| Niederauer,2017,UAS (35) | SOC(50)/TOT(50) | 12 | 59.1 ± 13.3/57.5± 10.9 | 40/39 | NA | 3.9 ± 2.0/3.4 ± 1.5 | Rates of closure, and time to closure |
| Niederauer,2018,UAS (36) | SOC(72)/TOT(74) | 12 | 56.6 ± 14.4/56.1 ± 10.1 | 54/59 | 20.54 ± 13.96/18.8 ± 12.7 | 3.89 ± 2.02/3.54 ± 1.68 | Full wound closure |
| Janelle,2016,Canada (37) | SOC(10)/TOT(10) | 8 | 58± 9.5/57 ± 9.5 | NA | 46.2 ± 17.9/47.4 ± 23.4 | 1.68 ± 1.31/1.37 ± 0.95 | Rates of closure, and time to closure |
| Chen,2017,China (38) | SOC(18)/HBOT(20) | 4 | 60.8 ± 7.2/64.3 ± 13.0 | 11/10 | 4.98 ± 4.8/8.44 ± 6.97 | NA | Physiological indices and blood biochemistry tests |
| Fedorko,2016,Canada (39) | SOC(54)/HBOT(49) | 12 | 62/61 | 38/31 | 48/33 | 5.1/6.1 | Amputation and wound healing |
| Ma,2013,China (40) | SOC(18)/HBOT(18) | 2 | 60.4 ± 5.6/59.8 ± 6.5 | 12/11 | 45.2 ± 34/57.2 ± 46.4 | 4.35 ± 1.04/4.21 ± 0.99 | Complete wound healing |
| Santema,2018, Netherlands (41) |
SOC(60)/HBOT(60) | 48 | 70.6 ± 11.2/67.6 ± 10.0 | 46/51 | 24/22.4 | 3.5 ± 2.9/3.2 ± 2.7 | Limb salvage and wound healing after 12 months, as well as time to wound healing. |
| Chaudhary,2013,India (42) | SOC(20)/HBOT(20)/PRP(20 | 60 | 45 ± 7.5/43.8 ± 9.4/43.3 ± 8.1 | 11/10/11 | 6.75 ± 2.65/6.83 ± 2.5/7.6 ± 2.53 | 9.9 ± 5.5/14.9 ± 6.2/19.2 ± 11.3 | Complete wound healing |
| Londahl,2010, Sweden (43) |
SOC(45)/HBOT(49) | 8 | 69/68 | 38/38 | 40/36 | 2.8/3.1 | Complete wound healing |
| Salama,2019,Egypt (44) |
SOC(15)/HBOT(15) | 8 | 57.7 ± 6.7/55.1 ± 7.5 | 10/12 | 15.5 ± 1.4/16.5± 1.5 | 8(2-16.5)/7.5 (1.5-15.5) | Complete healing of the target ulcer |
| Kumar,2020,India (45) |
SOC(26)/HBOT(28) | 6 | 56.9 ± 11.1/58.4 ± 10.1 | 19/20 | 36 ± 11.6/32 ± 8.4 | 3.0 ± 2.8/2.9 ± 1.5 | Healing and need for amputation,grafting or debridement |
| Lonardi,2019,Italy (46) |
SOC(50)/SCs(55) | 24 | 71.6 ± 10.8/69.0 ± 11.6 | 41/45 | NA | NA | The healing rate and time |
| Smith,2020, UK (47) | SOC(6)/SCs(6)/PRP+SCs(6) | 12 | 55.2/60.2/57.5 | 4/6/5 | 49/41/54 | 0.64/0.31/0.13 | Wound size and Wound healing |
| E.Uzun,2020. Turkey (48) |
SOC(10)/SCs(10) | 24 | 57.2 ± 4.5/57.5 ± 8.4 | 6/6 | 6.8 ± 2.4/7.8 ± 2.9 | 25.8 ± 5.4/23.5 ± 5.6 | Wound characteristics, wound closure time, amputation rates and clinical scores |
| Han,2010,Korea (49) | SOC(26)/SCs(26) | 8 | 68.4 ± 8.7/66.5 ± 7.5 | 14/15 | 4.0 ± 2.1/4.3 ± 2.1 | 12.5 ± 5.5/12.5 ± 5.6 | The percentages of complete healing and mean healing times |
| Meamar,2021,Iran (50) |
SOC(7)/SCs(11)/SCs+PRP(10) | 16 | 56 ± 10.5/68 ± 8.1 | NA | NA | 8.6 ± 5.5/11.11 ± 5.8,/11.2 ± 5.6 | Wound area and pain free walking distance |
| Brigido,2006,USA (51) |
SOC(14)/ADM(14) | 16 | 66/61 | NA | NA | NA | Complete wound healing |
| Driver,2015,USA (52) | SOC(153)/ADM(154) | 16 | 57.3 ± 9.7/55.8 ± 10.6 | 114/118 | NA | 3.65 ± 2.7/3.53± 2.5 | Complete wound healing |
| Walters,2016,USA (53) |
SOC(56)/ADM(76) | 16 | 57.1 ± 10.9/58.4 ± 11.7 | NA | NA | 3.3 ± 2.5/3.6 ± 4.2 | Complete wound healing |
| Reyzelman,2009, USA (54) |
SOC(39)/ADM(46) | 12 | 58.9 ± 11.6/55.4 ± 9.6 | NA | 22.9 ± 12.0/23.3 ± 16.0 | 5.1 ± 3.2/3.6 ± 2.2 | The proportion of healed diabetic foot ulcers and mean healing time |
| Zelen, 2016, USA (55) | SOC(20)/ADM(20) | 12 | 57.1 ± 10.65/61.5 ± 10.85 | 12/16 | NA | 2.7 ± 2.26/4.7 ± 5.24 | Complete wound healing |
| Zelen, 2018, USA (56) | SOC(40)/ADM(40) | 12 | 62/59 | 24/28 | NA | 2.7/3.2 | The proportion of wounds closed |
| Gao, 2022, China (57) | SOC(50)/UD(50) | 4 | 66/67 | 26/27 | NA | 14.5 ± 0.9/15.6 ± 0.8 | Patients total clinical efficiency, adverse events, ulcer areas, healing rate, and positive bacterial culture rate |
| Rastogi,2019,India (58) |
SOC(50)/UD(50) | 4 | 51.2 ± 7.3/52.5 ± 7.2 | NA | 12.1 ± 10.9/15.8 ± 11.2 | 14.8 ± 13.8/11.3± 8.2 | A >50% reduction in wound area |
| Li,2016,China (59) | NPWT(35)/NPWT+UD(35) | NA | 40.13 ± 13.2/40.43 ± 12.0 | 23/21 | 25.3 ± 12.4/23.3 ± 11.3 | 30 ± 23.4/36 ± 19.8 | The ulcer area,granulation tissue coverage rate and ulcer recurrence rate |
| Wang,2018,China (60) | NPWT(30)/NPWT+UD(30) | NA | 61.5 ± 8.5/60.5 ± 8.5 | 20/18 | NA | 1.81 ± 0.42/4.04 ± 0.76 | The number of changing times, the wound healing time and the incidence of adverse reactions |
| Li,2022,China (61) | NPWT(20)/NPWT+UD(20) | NA | 61.0 ± 9.81/58.85 ± 6.98 | 15/13 | NA | NA | The treatment effects,pain degree, ankle-brachial index and complication rate |
| Diao,2022,China (62) | NPWT(30)/NPWT+UD(30) | 2 | 49.85 ± 2.26/49.97 ± 2.39 | 17/19 | 18.3 ± 4.6/18.5 ± 4.5 | 12.42 ± 1.18/12.19 ± 1.21 | The clinical treatment effect, pain score and expression of serum inflammatory factors |
| Ji,2019,China (63) | NPWT(76)/NPTW+UD(77) | NA | 56.12 ± 8.60/55.75 ± 8.51 | 38/42 | 4.7 ± 0.7/32.4.7 ± 0.6 | 19.28 ± 6.42/15.28 ± 5.79 | The bacterial clearance rate, wound surface reduction and wound surface reduction rate |
| Seidel,2020,Germany (64) | SOC(174)/NPWT(171) | 16 | 68.1/67.6 | 134/133 | 23.2 ± 12.1/31.0 ± 11.6 | 11.4 ± 4.7/10.6± 5.5 | Wound closure |
| Maranna,2021,India (65) |
SOC(23)/NPWT(22) | 21 | 49.00 ± 10.14/50.23 ± 10.52 | 17/16 | 38.9 ± 12.9/36.9 ± 12.5 | 47.30 ± 17.00/48.45 ± 17.42 | The formation of granulation tissue, reduction in ulcer size, duration of hospital stay and time for complete healing of wounds |
| Vivek,2022, India (66) | SOC(32)/NPWT(23) | 3 | 36.74 ± 7.22/37.32 ± 6.84 | 26/16 | 30.2 ± 10.9/34.2 ± 8.5 | 19.87 ± 3.66/20.46 ± 3.45 | Wound healing |
| Sangma,2019,India (67) |
SOC(32)/NPWT(23 | 3 | 52.89/55.85 | 15/16 | NA | 80.44/70.97 | The time to wound healing, granulation tissue formation, and complications such as pain, infection, and bleeding |
| Erhan,2018,Turkey (68) |
SOC(34)/NPWT(31) | NA | 58.3 ± 8.0/60.6 ± 11.6 | 27/25 | 20.3 ± 11.2/25.2 ± 14.7 | 17.6 ± 3.3/18.3 ± 3.1 | Wound healing |
| Muhammad,2015, Pakistan (69) |
SOC(139)/NPWT(139) | 2 | 55.88 ± 10.97/56.83 ± 11.3 | 114/107 | NA | 15.07 ± 2.92/15.09 ± 2.81 | Reduction in wound area |
| Chen,2021, China (70) | NPWT(50)/PRP+ NPWT(50) |
6 | 60.88 ± 7.98/61.62 ± 8.35 | 27/29 | NA | NA | The total effective rates and the effect of wound repair |
| Gao, 2021, China (71) | NPWT(49)/NPWT+PRP(49) | NA | 59. 2± 6. 7/60. 7 ± 6. 9 | 29/30 | NA | NA | The formation of granulation tissue and new blood vessels, healing time |
| Chen,2018, China (72) | SOC(30)/PRP+ NPWT(28) |
NA | 49.59 ± 1.54/49.54 ± 1.55 | 12/13 | NA | NA | The hospitalization time and ulcer healing time |
| Niu,2020,China (73) | SOC(35)/PRP+NPWT(38) | NA | 59.62 ± 5.33/58.49 ± 4.97 | 19/20 | NA | NA | Wound healing |
| Wan, 2021, China (74) | NPWT(55)/PRP+NPWT(55) | 2 | 54.66 ± 8.79/53.25 ± 9.56 | 27/28 | NA | 2.49 ± 0.26/2.57 ± 0.52 | Treatment effect, ulcer healing time,hospital stay,blood biochemical indexes before and after treatment |
| Ahmed,2016,Egypt (75) |
SOC(28)/PRP(28) | 12 | 49.8 ± 15.4/43.2± 18.2 | 18/20 | 11.5 ± 2.8/12.5 ± 1.0 | 5.72 ± 0.48/6.24 ± 0.77 | Complete healing |
| Ajay,2021,India (29) | SOC(30)/PRP(30) | 6 | 55.76 ± 10.2/56.03± 9.6 | 19/22 | 44.9 ± 70.8/54.8 ± 70.3 | 4.96± 2.89/5.22 ± 3.82 | Wound healing |
| Alamdari,2021,Iran (76) |
SOC(47)/PRP(43) | 24 | 56.7 ± 7.2/56.3 ± 7.1 | 30/26 | NA | NA | The healing rate of foot ulcers |
| Shailendra,2018,India (77) | SOC(26)/PRP(29) | 4 | 55.69 ± 10.35/53.76 ± 10.38 | 15/19 | NA | NA | Wound healing |
| Ahmed,2019,Egypt (78) |
SOC(12)/PRP(12) | 20 | 55.6 ± 6.5/54.7 ± 6.6 | 6/8 | 22.3± 10.8/21 ± 13.6 | 15.16 ± 2.1/25.58± 8.32 | Percent reduction in the dimensions of the DFU, healing of DFU, and complications at 20 weeks of follow-up |
| Yasser,2022,Egypt (79) |
SOC(36)/PRP(36) | 20 | 58.69 ± 6.68/56.03± 8.39 | 21/20 | 46.67 ± 39.87/46.64 ± 31.47 | 3.22 ± 1.2/3.33± 1.31 | Wound healing |
| ElMahdy,2021,Egypt (80) |
SOC(40)/PRP(40) | 12 | 54.8± 3.9/54.9 ± 2.37 | 34/28 | NA | 14.5 ± 5.6/15.2 ± 5.6 | Wound healing and decrease the rate of local infection |
| Xie,2019,China (81) | SOC(23)/PRP(25) | 8 | 61.10 ± 7.90/60.50 ± 8.27 | 13/14 | 24.3 ± 16.96/21.60 ± 18.50 | 11.78 ± 7.78/11.84 ± 9.67 | The sinus tract closure times, ulcer healing rates, hospitalization times, and hospitalization expenses |
| Li,2014,China (82) | SOC(55)/PRP(48) | 12 | 64.1 ± 9.4/61.4 ± 13.1 | 38/37 | 3.3/4.3 | 2.9/4.1 | Wound healing |
| Li,2022,China (83) | SOC(36)/PRP(36) | 12 | 64.2 ± 9.8/62.5 ± 10.1 | 20/22 | 3.1 ± 2.4/3.3 ± 2.1 | 26.9 ± 18.3/28.2 ± 17.8 | Healing time (days), length of hospital stay (days), healing rate, surface area reduction (cm2), and adverse events |
| Asad,2022,Pakistan (84) |
SOC(80)/PRP(80) | 24 | 57.7 ± 10.1/54.4 ± 8.5 | 14/13 | NA | NA | Wound healing |
| Du,2022,China (85) | SOC(30)/PRP(30) | 14 | 53.4/54.44 | 17/19 | NA | 7.244 ± 1.24/7.4 ± 1.6 | Healing area, volume, and rates |
| Jeong,2010,Korea (86) | SOC(48)/PRP(52) | 12 | 63.8 ± 6.4/64.5± 8.1 | 26/27 | 10.1± 3.1/12.4 ± 5.6 | 5.3 ± 2.2/5.7 ± 3.6 | The percentage of complete healing, mean healing time, percentage of wound shrinkage, and patient satisfaction |
| Hossam,2021,Egypt (80) |
SOC(40)/PRP(40) | 12 | 54.8 ± 3.9/54.9± 2.37 | 34/28 | NA | 14.5 ± 5.6/15.2 ± 5.6 | Wound healing and the rate of local infection |
| Arash,2022,Iran (87) | SOC(81)/PRP(81) | 12 | 60.2 ± 5.2/55.8 ± 5.6 | 46/52 | 6.4 ± 1.8/6.0 ± 0.7 | 3.3 ± 0.5/3.2 ± 0.5 | The percentage area reduction |
NA, Not Available.