Prospective randomized controlled study of Hydrofiber® dressing containing ionic silver or calcium alginate dressings in non‐ischaemic diabetic foot ulcers

Jude, Edward B.; Apelqvist, Jan; Spraul, Maximilian; Martini, Jacques

doi:10.1111/j.1464-5491.2007.02079.x

Cited by 137 publications

(93 citation statements)

References 27 publications

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“…Pooling the three hydrogel RCTs suggested that hydrogels are significantly more effective than gauze or standard care in healing diabetic foot ulcers [8]. Adding silver into the dressing also demonstrated to be extra efficacious [9]. Surgical debridement [23] and larval therapy [21] showed no significant benefit [8].…”

Section: Resultsmentioning

confidence: 99%

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The value of debridement and Vacuum-Assisted Closure (V.A.C.) Therapy in diabetic foot ulcers

Eneroth

Houtum

2008

Diabetes Metab. Res. Rev.

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Section: Resultsmentioning

confidence: 99%

“…Pooling the three hydrogel RCTs suggested that hydrogels are significantly more effective than gauze or standard care in healing diabetic foot ulcers [8]. Recently, a trial with hydro-fibres with added ionic silver demonstrated a better clinical outcome for ulcers treated with dressings containing silver [9].…”

Section: Autolytic Debridementmentioning

confidence: 99%

The value of debridement and Vacuum-Assisted Closure (V.A.C.) Therapy in diabetic foot ulcers

Eneroth

Houtum

2008

Diabetes Metab. Res. Rev.

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“…We therefore focused our analyses on the proportion of ulcers healed (or risk of healing). In terms of ulcer severity, four studies 263,268,269,273 reported the inclusion of people with Wagner grade 1 or 2 ulcers and one study 264 specified that ulcers were superficial. A further three studies specified that people with ulcers involving tendons, joint spaces and/or bone were excluded.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…[261][262][263][264][265][266][267][268][269][270][271][272][273][274][275] A Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flowchart is presented in Appendix 12 and a summary of study characteristics for the included studies is presented in Table 65. All 15 included studies reported the number of ulcers healed, whereas only three 262,264,266 reported median time to healing.…”

Section: Study Characteristicsmentioning

confidence: 99%

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Wounds research for patient benefit: a 5-year programme of research

Cullum

Buckley

Dumville

et al. 2016

Programme Grants Appl Res

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BackgroundComplex wounds are those that heal by secondary intention and include lower-limb ulcers, pressure ulcers and some surgical wounds. The care of people with complex wounds is costly, with care mainly being delivered by community nurses. There is a lack of current, high-quality data regarding the numbers and types of people affected, care received and outcomes achieved.ObjectivesTo (1) assess how high-quality data about complex wounds can be captured effectively for use in both service planning and research while ensuring integration with current clinical data collection systems and minimal impact on staff time; (2) investigate whether or not a clinical register of people with complex wounds could give valid estimates of treatment effects, thus reducing dependence on large-scale randomised controlled trials (RCTs); (3) identify the most important research questions and outcomes for people with complex wounds from the perspectives of patients, carers and health-care professionals; (4) evaluate the potential contributions to decision-making of individual patient data meta-analysis and mixed treatment comparison meta-analysis; and (5) complete and update systematic reviews in topic areas of high priority.MethodsTo meet objectives 1 and 2 we conducted a prevalence survey and developed and piloted a longitudinal disease register. A consultative, deliberative method and in-depth interviews were undertaken to address objective 3. To address objectives 4 and 5 we conducted systematic reviews including mixed treatment comparison meta-analysis.ResultsFrom the prevalence survey we estimated the point prevalence of all complex wounds to be 1.47 per 1000 people (95% confidence interval 1.38 to 1.56 per 1000 people). Pressure ulcers and venous leg ulcers were the most common type of complex wound. A total of 195 people with a complex wound were recruited to a complex wounds register pilot. We established the feasibility of correctly identifying, extracting and transferring routine NHS data into the register; however, participant recruitment, data collection and tracking individual wounds in people with multiple wounds were challenging. Most patients and health professionals regarded healing of the wound as the primary treatment goal. Patients were greatly troubled by the social consequences of having a complex wound. Complex wounds are frequently a consequence of, and are themselves, a long-term condition but treatment is usually focused on healing the wound. Consultative, deliberative research agenda setting on pressure ulcer prevention and treatment with patients, carers and clinicians yielded 960 treatment uncertainties and a top 12 list of research priorities. Of 167 RCTs of complex wound treatments in a systematic review of study quality, 41% did not specify a primary outcome and the overall quality of the conduct and reporting of the research was poor. Mixed-treatment comparison meta-analysis in areas of high priority identified that matrix hydrocolloid dressings had the highest probability (70%) of being the most effective dressing for diabetic foot ulcers, whereas a hyaluronan fleece dressing had the highest probability (35%) of being the most effective dressing for venous ulcers; however, the quality of this evidence was low and uncertainty is high.ConclusionsComplex wounds are common and costly with a poor evidence base for many frequent clinical decisions. There is little routine clinical data collection in community nursing. A prospective complex wounds register has the potential to both assist clinical decision-making and provide important research evidence but would be challenging to implement without investment in information technology in NHS community services. Future work should focus on developing insights into typical wound healing trajectories, identifying factors that are prognostic for healing and assessing the cost-effectiveness of selected wound treatments.FundingThe National Institute for Health Research Programme Grants for Applied Research programme.

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Debridement of diabetic foot ulcers

Edwards

Stapley

2010

Cochrane Database of Systematic Reviews

159

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Surgical and non-surgical methods of cleaning and removing dead tissue from sores on the feet of people with diabetes. People with diabetes o en develop foot ulcers (open sores on the feet that go through the skin), which are a serious complication and can themselves result in serious consequences such as amputation. Cleaning and removing dead tissue and callus from the ulcers is a common procedure also know as "debridement" and can be done in several ways, including surgery and special dressings and gels (such as hydrogels). The review found that hydrogel results in faster healing than gauze or standard care. The evidence for other debriding strategies is unclear.

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Prospective randomized controlled study of Hydrofiber® dressing containing ionic silver or calcium alginate dressings in non‐ischaemic diabetic foot ulcers

Cited by 137 publications

References 27 publications

The value of debridement and Vacuum-Assisted Closure (V.A.C.) Therapy in diabetic foot ulcers

The value of debridement and Vacuum-Assisted Closure (V.A.C.) Therapy in diabetic foot ulcers

Wounds research for patient benefit: a 5-year programme of research

Debridement of diabetic foot ulcers

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