A Meta-analysis of human amniotic membrane for diabetic foot ulcer

Abstract

Objective To evaluate the safety and effectiveness of application of human amniotic membrane on the treatment of diabetic foot ulcer. Methods Databases including Cochrane Central Register of Controlled Trails, PubMed, Embase, OVID, CBMDisc, CNKI, Chinese VIP Database and WANFANG Database were applied and proceedings of the American Diabetes Association were manually retrieved to select randomized controlled trials over application of human amniotic membrane on the treatment of diabetic foot ulcer published until February 2017. The bibliographies of retrieved articles were also retrieved. Two researchers selected studies according to inclusion and exclusion criteria, extracted related data, and conducted Meta-analysis by RevMan5.3 statistical software independently. Results Totally 9 studies containing 595 patients with diabetic foot ulcer were included. Meta-analysis showed: (1) Diabetic foot ulcer healing rate: Human amniotic membrane was superior to conventional treatment [71.38% (212/297) vs 28.19% (84/298) , RR=2.54, 95%CI: 2.10-3.07, P<0.001]. (2) Diabetic foot ulcer healing time: Human amniotic membrane was superior to conventional treatment (SMD=-0.97, 95%CI: -1.38--0.56, P<0.001). (3) Area reduction rate of diabetic foot ulcer: Two studies showed that human amniotic membrane might had the effect of improving the area of ulcer reduction rate (P<0.001) . (4) Complications: No patient in these trials had complications or side effect associated with human amniotic membrane. Conclusion According to the Meta-analysis of the 9 studies, human amniotic membrane dressing is effective and safe in the treatment for diabetic foot ulcer, but further studies are needed. Key words: Diabetic foot; Foot ulcer; Biological dressings; Meta-analysis