Systematic review and mixed treatment comparison: dressings to heal diabetic foot ulcers
Diabetologia - Clinical and Experimental Diabetes and Metabolism, 05/17/2012
Evidence Based Medicine
Dumville JC et al. – The findings summarise all available trial evidence regarding the use of dressings to heal diabetic foot ulcers. More expensive dressings may offer no advantages in terms of healing than cheaper basic dressings. In addition, evidence pointing to a difference in favour of ‘advanced’ dressing types over basic wound contact materials is of low or very low quality.Methods
- This study was a systematic review involving Bayesian mixed treatment comparison.
- The authors included randomised controlled trials evaluating the effects on diabetic foot ulcer healing of one or more wound dressings.
- There were no restrictions based on language or publication status.
- Fifteen eligible studies, evaluating nine dressing types, were included.
- Ten direct treatment comparisons were made.
- Whilst there was increased healing associated with hydrogel and foam dressings compared with basic wound contact materials, these findings were based on data from small studies at unclear or high risk of bias.
- The mixed treatment comparison suggested that hydrocolloid–matrix dressings were associated with higher odds of ulcer healing than all other dressing types; there was a high degree of uncertainty around these estimates, which were deemed to be of very low quality.