What Researchers Did
Researchers pooled results from 5 clinical trials to see how well extracorporeal shockwave therapy (ESWT) helps diabetic foot ulcers heal.
What They Found
This systematic review and meta-analysis of 5 trials involving 255 patients found that ESWT was superior to standard wound care for complete wound healing, with an odds ratio of 2.66 (95% confidence interval 1.03 to 6.87). Of the 5 trials, 3 compared ESWT to standard wound care and 2 compared ESWT to hyperbaric oxygen therapy (HBOT); the abstract does not report a specific result, odds ratio, or direction of effect for that ESWT-versus-HBOT comparison. All 5 included studies carried an unclear to high risk of bias on the Cochrane Risk of Bias Tool.
What This Means for Canadian Patients
For patients with diabetic foot ulcers, this review suggests ESWT may improve wound healing compared with standard wound care alone, but the study authors state there is not yet enough evidence to justify using it in routine clinical practice. Two of the pooled trials compared ESWT directly against HBOT, but since the abstract does not state which treatment came out ahead in that comparison, no conclusion about ESWT versus HBOT for foot ulcers can be drawn from this study.
Canadian Relevance
No direct Canadian connection identified.
Study Limitations
The authors report that all included trials had unclear to high risk of bias, meaning the pooled result is unlikely to reflect the true effect size, and they point to variable trial quality and inconsistent shockwave dosing as reasons larger, better-designed trials are still needed.