Efficacy and safety of negative pressure wound therapy combined with alginate dressings for wound management: a meta-analysis

Background Wound management remains a clinical challenge, with single-modality therapies such as negative pressure wound therapy (NPWT) or conventional dressings often failing to optimize healing efficiency and quality. This study aimed to systematically evaluate the clinical efficacy of NPWT combined with alginate dressings in wound treatment, providing evidence for clinical decision-making. Methods A comprehensive search was conducted across Chinese and English databases from database inception to 30 November 2025. Randomized controlled trials (RCTs) comparing NPWT combined with alginate dressings (combined group) versus NPWT alone or routine dressing changes (control group) were included. Two researchers independently performed literature screening, data extraction, and risk of bias assessment using the Cochrane RoB 2.0 tool. Meta-analysis was conducted with RevMan 5.4 software. Results A total of 11 RCTs involving 902 participants were included. Pooled results showed that the combined group significantly improved wound healing rate (OR = 2.64, 95% CI 1.60–4.36, I 2 = 30%) and Grade-A healing rate (OR = 4.69, 95% CI 2.56–8.57, I 2 = 0%), shortened healing time (days) (MD = −9.00, 95% CI -9.41 to −8.58, I 2 = 83%), reduced dressing change frequency (MD = −2.54, 95% CI -2.92 to −2.17, I 2 = 77%), and decreased wound pH value (MD = −0.82, 95% CI -1.08 to −0.57, I 2 = 61%) compared with the control group. Heterogeneity was moderate to high for partial outcomes, mainly attributed to variations in NPWT parameters (100–500 mmHg) and dressing protocols. No significant publication bias was detected (all p > 0.05). Conclusion This meta-analysis finds that NPWT combined with alginate dressings significantly improves wound healing outcomes compared to monotherapy, with benefits observed primarily in hospital-based settings. While this combined regimen should be prioritized for complex or chronic wounds, judicious application of parameters—including careful monitoring at higher negative pressures—is warranted, and further health economic evaluation and standardized safety reporting are needed to optimize clinical decision-making.