Meta-analysis of vacuum-sealing drainage combined with antibiotic bone cement in the treatment of chronic osteomyelitis / 中国组织工程研究

ABSTRACT

OBJECTIVE: Vacuum-sealing drainage has the effect of promoting wound healing and preventing infection. At present, a large number of studies have confirmed the significant efficacy of vacuum-sealing drainage combined with antibiotic bone cement in the treatment of chronic osteomyelitis, but the corresponding evidence is still lacking. A meta-analysis was performed on the effect of treatment of chronic osteomyelitis by vacuum-sealing drainage combined with antibiotic bone cement. METHODS: CNKI, VIP, Wanfang, PubMed, Cochrane Library and EMbase were searched to find randomized controlled trials of vacuum-sealing drainage combined with antibiotic bone cement for the treatment of chronic osteomyelitis. The retrieval time was from inception to February 2020. The quality of the included literature was strictly evaluated, and the RevMan 5.3 software was used for meta-analysis of the included research. RESULTS: Ten randomized controlled trials involving 637 patients with chronic osteomyelitis were included, with the treatment group of 313 cases and control group of 324 cases. Due to the special wound therapy, it was difficult to implement blind method clinically, so there was partial implementation bias. (2) Metaanalysis results showed that the recurrence rate of chronic osteomyelitis treated with vacuum-sealing drainage with antibiotic bone cement was lower than that in the control group (OR=0.20, 95%CI0.11-0.37, P < 0.000 01). In the healing rate (OR=3.44, 95%CI2.01-5.92, P < 0.000 01), healing time (MD=-11.05, 95%CI-18.59 to-3.52, P=0.004), duration of antibiotic use (MD=-12.36, 95%CI-13.27 to-11.44, P < 0.000 01), visual analogue scale score (MD=-1.94, 95%CI-2.80 to-1.08, P < 0.000 01), times of dressing change (MD=-5.78, 95%CI-6 .64 to-5.12, P < 0.000 01), bone absorption time (MD=-0.81, 95%CI-0.98 to-0.64, P < 0.000 01), and bone healing time (MD=-1.62, 95%CI-2.22 to-1.03, P < 0.000 01) were all better in the vacuum-sealing drainage with antibiotic bone cement group than those in the control group. CONCLUSION: The combination of vacuum-sealing drainage and antibiotic bone cement in the treatment of chronic osteomyelitis has a significant advantage over the traditional treatment, which is worthy of clinical promotion. Limited by the quantity and quality of the included studies, the above conclusions need to be verified by more high-quality clinical studies.