Systematic review and mixed treatment comparison: dressings to heal diabetic foot ulcers

Dumville, J. C., Soares, M. O., O'Meara, S. and Cullum, N. (2012) Systematic review and mixed treatment comparison: dressings to heal diabetic foot ulcers. Diabetologia, 55 7: 1902-1910. doi:10.1007/s00125-012-2558-5


Author Dumville, J. C.
Soares, M. O.
O'Meara, S.
Cullum, N.
Title Systematic review and mixed treatment comparison: dressings to heal diabetic foot ulcers
Journal name Diabetologia   Check publisher's open access policy
ISSN 0012-186X
1432-0428
Publication date 2012-07
Sub-type Article (original research)
DOI 10.1007/s00125-012-2558-5
Open Access Status
Volume 55
Issue 7
Start page 1902
End page 1910
Total pages 9
Place of publication Heidelberg, Germany
Publisher Springer
Language eng
Formatted abstract
Aims/hypothesis
Foot ulcers in people with diabetes are a common and serious global health issue. Dressings form a key part of ulcer treatment. Existing systematic reviews are limited by the lack of head-to-head comparisons of alternative dressings in a field where there are several different dressing options. We aimed to determine the relative effects of alternative wound dressings on the healing of diabetic foot ulcers.

Methods

This study was a systematic review involving Bayesian mixed treatment comparison. We 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.

Results

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.

Conclusions/interpretation
These 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.
Keyword Diabetic foot ulcers
Dressings
GRADE
Mixed treatment comparison
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Nursing, Midwifery and Social Work Publications
 
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Created: Thu, 22 May 2014, 09:49:23 EST by Vicki Percival on behalf of School of Nursing, Midwifery and Social Work