Rédacteur : Johan Nguyen

pressure ulcer

Escarres de décubitus

1. Systematic Reviews and Meta-Analysis

☆☆☆ Evidence for effectiveness and a specific effect of acupuncture
☆☆ Evidence for effectiveness of acupuncture
Limited evidence for effectiveness of acupuncture
Ø No evidence or insufficient evidence

1.1. Generic Acupuncture

1.1.1. Wang 2022 ☆

Wang F, Chen M, Du J. Effect of Chinese herbal topical medicine, acupuncture, and moxibustion on pressure ulcer wound healing: A meta-analysis. Int Wound J. 2022 Dec;19(8):2031-2038. https://doi.org/10.1111/iwj.13803

ObjectiveWe performed a meta-analysis to evaluate the effect of Chinese herbal topical medicine, acupuncture, and moxibustion on pressure ulcer wound healing.
Methods and Results A systematic literature search up to January 2022 was done and 13 studies included 1073 subjects with pressure ulcer wound at the start of the study; 593 of them were using traditional Chinese medicine treatments, and 480 were control for pressure ulcer wound. We calculated the odds ratio (OR) with 95% confidence intervals (CIs) to evaluate the effect of Chinese herbal topical medicine, acupuncture, and moxibustion on pressure ulcer wound healing by the dichotomous methods with a random or fixed-influence model. Traditional Chinese medicine treatments had significantly higher complete healing (OR, 5.94; 95% CI, 3.94-8.95, P < .001), and curative ratio post-treatment (OR, 4.79; 95% CI, 2.62-8.76, P < .001) compared with control for subjects with pressure ulcer wound.
ConclusionsTraditional Chinese medicine treatments had a significantly higher complete healing and curative ratio post-treatment compared with control for subjects with pressure ulcer wounds. Further studies are needed to validate these findings.

1.1.2. Zhang 2013 Ø

Zhang QH, Sun ZR, Yue JH, Ren X, Qiu LB, Lv XL, Du W. Traditional chinese medicine for pressure ulcer: a meta-analysis. Int Wound J. 2013;10(2):221-31. [166388].

Backgound To assess the effect of Traditional Chinese Medicine (TCM) [Chinese herbal medicine ointment (CHMO), acupuncture and moxibustion] on pressure ulcer.
MethodIn this study, we searched MEDLINE, EMBASE, CENTER, CBM, CNKI, WAN FANG and VIP for articles published from database inception up to 4 April 2011. We included randomised controlled trials (RCTs), which compared the effects of TCM with other interventions. We assessed the methodological quality of these trials using Cochrane risk of bias criteria.
ResultsTen of 565 potentially relevant trails that enrolled a total of 893 patients met our inclusion criteria. All the included RCTs only used CHMO intervention, because acupuncture and moxibustion trials failed to meet the inclusive criteria. A meta-analysis showed beneficial effects of CHMO for pressure ulcer compared with other treatments on the total effective rate [risk ratio (RR): 1•28; 95% confidence interval (CI): 1•20-1•36; P = 0•53; I(2) = 0%), curative ratio (RR: 2•02; 95% CI: 1•73-2•35; P = 0•11; I(2) = 37%) and inefficiency rate (RR: 0•16; 95% CI: 0•02-0•80; P = 0•84; I(2) = 0%). However, the funnel plot indicated that there was publication bias in this study.
Conclusion The evidence that CHMO is effective for pressure ulcer is encouraging, but due to several caveats, not conclusive. Therefore, more rigorous studies seem warranted.

1.2. Special Acupuncture Techniques

1.2.1. Comparison of Acupuncture techniques

1.2.1.1. Cui 2023

Cui Y, Zhou X, Sun Z, Yin H. Efficacy of acupuncture therapies on pressure injury: A systematic review and network meta-analysis. Asian J Surg. 2023 Nov;46(11):5224-5226. https://doi.org/10.1016/j.asjsur.2023.07.009

In conclusion, our study suggests acupuncture is an effective and safe strategy for treating PI. Heat-sensitive moxibustion combined with standard wound care was the most effective acupuncture-related technique in promoting PI healing. Moreover, electroacupuncture with standard wound care was the best acupuncture treatment for relieving PI-related pain. However, owing to the limitations of our study experienced (Appendix), these findings should be interpreted with caution.