Hydrogel dressings for healing diabetic foot ulcers

Cochrane Database of Systematic Reviews, 2011

Publication History Publication Status: New Published Online: 7 SEP 2011 SEARCH ARTICLE TOOLS Abstract Abstract Background Foot ulcers in people with diabetes are a prevalent and serious global health issue.
Dressings form a key part of ulcer treatment, with clinicians and patients having many different types to choose from including hydrogel dressings.
A clear and current overview of current evidence is required to facilitate decision-making regarding dressing use.
Objectives To assess the effects of hydrogel wound dressings compared with alternative dressings or none on the healing of foot ulcers in people with diabetes.
Selection criteria Published or unpublished randomised controlled trials (RCTs) that have compared the effects on ulcer healing of hydrogel with alternative wound dressings or no dressing in the treatment of foot ulcers in people with diabetes.
Data collection and analysis Two review authors independently performed study selection, risk of bias assessment and data extraction.
Meta analysis of three studies comparing hydrogel dressings with basic wound contract dressings found significantly greater healing with hydrogel: risk ratio (RR) 1.80, 95% confidence interval (CI) 1.27 to 2.56.
The three pooled studies had different follow-up times (12 weeks, 16 weeks and 20 weeks) and also evaluated ulcers of different severities (grade 3 and 4; grade 2 and grade unspecified).
One study compared a hydrogel dressing with larval therapy and found no statistically significant difference in the number of ulcers healed and another found no statistically significant difference in healing between hydrogel and platelet-derived growth factor.
There was also no statistically significant difference in number of healed ulcers between two different brands of hydrogel dressing.
All included studies were small and at unclear risk of bias and there was some clinical heterogeneity with studies including different ulcer grades.