Effects of non-pharmacological interventions on ulcer healing in patients with diabetic foot: a network meta-analysis of randomized controlled trials.

Abstract

<h4>Background</h4>Diabetic Foot Ulcers are a serious complication of diabetes, and the clinical treatment is challenging. In this study, network meta-analysis was used to evaluate the effect of different non-drug interventions on Diabetic Foot Ulcer healing and provide evidence to support clinical decision-making.<h4>Methods</h4>Data sources: 8 databases, including PubMed, Embase, Cochrane, WOS, CNKI, Wanfang Data, CBM, and VIP, were systematically searched. Literature screening: According to the principle of PICOS, two researchers independently screened. Quality evaluation: Two researchers independently used the Cochrane bias risk assessment tool (RoB 2.0) to evaluate the risk of bias. Statistical analysis: by NMA of the random effects model under the framework of frequency.<h4>Results</h4>A total of 24 randomized controlled trials involving 15 types of interventions were included. The overall quality of the included literature was moderate. The results of NMA showed that Negative Pressure Wound Therapy + Standard Care had the best effect on 12-week healing rate. Compared with Standard Care, Gas Therapy+ Dressing Therapy + Standard Care had the best healing time.<h4>Conclusion</h4>Negative Pressure Wound Therapy + Standard Care may be more beneficial for improving the 12-week healing rate of Diabetic Foot Ulcer, while Gas Therapy + Dressing Therapy + Standard Care may show potential advantages in shortening healing time. However, these results rely on a limited number of small-sample studies with wide confidence intervals, indicating limited certainty of evidence. Consequently, the SUCRA rankings should be interpreted with caution as they are primarily exploratory; further high-quality RCTs are required to confirm these findings.<h4>Systematic review registration</h4>https://www.crd.york.ac.uk/prospero/, identifier CRD420251122143.