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Published on: May 2, 2025
Effectiveness of Negative Pressure Wound Therapy in Burns in Pediatric and Adolescent Patients: A Systematic Review
Celia Villalba-Aguilar1,2, Juan Manuel Carmona-Torres2,3,4, Lucía Villalba-Aguilar5
1Hospital Laboral Solimat, Calle San Pedro el Verde 35, 45004 Toledo, Spain.
Insights
Negative pressure wound therapy (NPWT) significantly improves burn healing in pediatric and adolescent patients by reducing healing time and scar appearance. This advanced therapy also lowers the need for skin grafts and associated costs, offering a promising treatment option.
Area of Science:
- Pediatric Surgery
- Wound Healing
- Biomedical Engineering
Background:
- Burns pose significant physical, psychological, and economic challenges, particularly for pediatric and adolescent populations.
- Scar management is a major cost driver in burn care.
- Negative pressure wound therapy (NPWT) has emerged as a promising intervention for improving burn healing and scar outcomes.
Purpose of the Study:
- To systematically analyze the efficacy of Negative Pressure Wound Therapy (NPWT) in pediatric and adolescent burn patients.
- To compare NPWT, alone or as an adjunct, against conventional dressings.
- To evaluate NPWT's impact on healing time, scar appearance, need for skin grafts, and associated costs.
Main Methods:
- A systematic literature search was conducted across PubMed, Scopus, CINAHL, and Cochrane Library from December 2023 to Q4 2025.
- The meta-analysis followed PRISMA guidelines and was registered with PROSPERO (CRD42024597293).
- Risk of bias was assessed using the RoB2 tool, with quantitative meta-analyses performed where data allowed, and qualitative synthesis for other outcomes.
Main Results:
- Seven studies (3 RCTs, 4 retrospective) with 323 participants were included.
- NPWT demonstrated reduced re-epithelialization time and improved scar appearance (MD = -1.25).
- NPWT significantly decreased the probability of requiring skin grafts (OR = 0.17) and reduced overall treatment costs.
Conclusions:
- Negative Pressure Wound Therapy (NPWT) provides substantial clinical benefits for treating burns in children and adolescents.
- NPWT is an effective adjunctive therapy that improves key clinical outcomes and reduces healthcare expenses.
- Further multicenter studies with larger sample sizes are recommended to solidify these findings and guide clinical practice.
Abstract:
Background: Burns represent a public health problem because they generate both physical and psychological damage, especially in the child and adolescent population, and high costs, especially due to the management of scars. Advances in burn care have improved survival and quality of life for this population. New clinical trials have been conducted on the benefits of negative pressure wound therapy (NPWT), showing that it improves the healing of burns and the appearance of scars. Therefore, this study aims to analyze the efficacy of NPWT both alone and as an adjunct to conventional dressings in pediatric and adolescent patients compared with conventional treatments. Methodology: A systematic search was carried out between December 2023 and the last quarter of 2025 in databases such as PubMed, Scopus, CINAHL, and the Cochrane Library. This meta-analysis was performed following the PRISMA statement (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and was registered in PROSPERO with registration number CRD42024597293. The risk of bias 2 (RoB2) tool was used to assess the risk of bias in the studies. Quantitative meta-analyses using random-model effects were performed only for variables with sufficient comparable data among studies. For other outcomes, where meta-analysis was not feasible due to lack of comparable data or control groups, results were synthesized qualitatively. Results: A total of seven articles (three clinical trials and four retrospective studies), in which a total of 323 subjects participated, were included. The main results demonstrate the efficacy of NPWT, as it decreases the re-epithelialization time, improves the appearance of scars (MD = -1.25 (95% CI between -1.80 and -0.70)), reduces the probability of skin grafts (OR = 0.17 (95% CI between 0.06 and 0.46)), and therefore, as there is less need for surgery and fewer dressing changes, reduces costs. Conclusions: NPWT offers significant clinical benefits in the treatment of burns in children and adolescents. Although a meta-analysis could not be performed due to the lack of a control group in some studies, studies with larger samples and multicenter designs will be necessary to better assess the relevant clinical outcomes. However, the results of this study show that NPWT is effective in treating burns in children and adolescents and that its use in clinical practice may represent a promising adjunctive therapy.
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