Negative pressure wound therapy (NPWT) has been evaluated across randomized controlled trials for its role in managing diabetic foot ulcers (DFU). A systematic review and meta-analysis published in the Journal of Diabetes assessed its effectiveness and safety compared with conventional wound care.

The analysis included 23 randomized controlled trials comprising 2,086 participants. Databases including PubMed, Cochrane Library, Embase, and Web of Science were searched through October 2025. Outcomes assessed included wound healing rate, ulcer area reduction, amputation rate, and adverse events. Pooled odds ratios (OR) and standardized mean differences (SMD) were calculated using random-effects models.

NPWT demonstrated higher wound healing rates compared with conventional care (OR 4.48; 95% CI 2.58-7.77) and greater reduction in ulcer area (SMD 1.26; 95% CI 0.70-1.82). The analysis also showed lower amputation risk with NPWT (OR 0.35; 95% CI 0.19-0.64). No difference in adverse events was observed between groups (OR 0.98; 95% CI 0.56-1.71). Subgroup analyses showed consistent findings across age groups, follow-up durations, and comparator dressings.

The magnitude of wound healing improvement was greater in less severe ulcers (Wagner grade <2), while the reduction in amputation risk remained consistent across ulcer severities. These findings reflect differences in wound healing, amputation outcomes, and safety profiles between NPWT and conventional wound care in DFU.