Comparison of the efficacy of 12 interventions in the treatment of diabetic foot ulcers: a network meta-analysis

Relatively higher-quality human studies compared with other topics in this database, e.g. multiple RCTs or systematic reviews. This does not mean it is standard or approved care.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

Objective This study aimed to comprehensively compare the efficacy of 12 interventions for diabetic foot ulcer (DFU) using a network meta-analysis (NMA). Methods The NMA was conducted by PRISMA guidelines, and the protocol was registered in PROSPERO (CRD42023461811). PubMed, Web of Science, Cochrane Library, and Embase databases were systematically searched from inception to September 2023. Randomized controlled trials (RCTs) enrolling patients with DFU were included if they compared epidermal growth factor (EGF), platelet-derived growth factor (PDGF), platelet-rich plasma (PRP), stem cells (SC), low-frequency ultrasound (LFU), negative pressure wound therapy (NPWT), low-level laser therapy (LLLT), electric stimulation (ES), extracorporeal shockwave therapy (ESWT), amniotic membrane therapy (AMT), hyperbaric oxygen therapy (HBOT), and topical oxygen therapy (TOT) against standard of care (SOC) or placebo. The primary endpoint assessed was the wound healing rate. Secondary endpoints comprised wound healing time, percentage area reduction (PAR), and amputation rate. The surface under the cumulative ranking curve (SUCRA) was calculated to rank the efficacy of interventions. Results A total of 99 RCTs involving 7,356 patients were included. Among the 12 interventions analyzed, only LFU (OR = 2.20; 95% CI [0.99-4.91]) and ES (OR = 1.88; 95% CI [0.87-4.05]) did not demonstrate statis

Evidence level

Relatively higher-quality human studies compared with other topics in this database, e.g. multiple RCTs or systematic reviews. This does not mean it is standard or approved care.

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