Snyder DL, Turkelson CM; International Society of Technology Assessment in Health Care. Meeting.
Annu Meet Int Soc Technol Assess Health Care Int Soc Technol Assess Health Care Meet. 2000; 16: 118.
Health Technology Assessment Group, ECRI, Plymouth Meeting, PA, USA
Introduction: This assessment examines the efficacy of occlusive dressings (films, foams, hydrogels, hydrocolloids, alginates) compared to nonocclusive dressings (wet or dry gauze, paste bandages) in the treatment of chronic wounds (pressure, venous leg, and diabetic foot ulcers). Unlike nonocclusive dressings, occlusive dressings form a barrier to bacterial invasion and promote wound healing by maintaining a moist wound environment. Methods: Only randomized control trials (RCTs) were considered. Studies were excluded for study design flaws (less than 10 patients per group, examination of multiple ulcers per patient, large patient drop out rates, and other flaws). Eleven of 15 pressure ulcer RCTs, eight of 19 venous leg ulcer RCTs, and two of three diabetic foot ulcer RCTs were excluded. Number of wounds healed and number of wounds infected were used to calculate an odds ratio comparing hydrocolloid dressings (examined in a majority of RCTs) to other occlusive or nonocclusive dressings. Results: The individual study odds ratios were not statistically different from 1.0 indicating that the dressings compared in each study were similar in their healing capacity. A meta-analysis of the odds ratio data also indicated no differences between dressings. Conclusions: Currently available evidence indicates that occlusive and nonocclusive dressings are not different in their capacity to promote healing in pressure ulcers and venous leg ulcers. No one type of occlusive dressing has been shown to be significantly superior to other occlusive dressings. Wounds treated with occlusive dressings or nonocclusive dressings have similar rates of infection. Insufficient data are available to assess patients with diabetic foot ulcers. Based on cost information reported in the literature, the use of occlusive dressings in treating pressure ulcers requires considerably less nursing time and is less costly than nonocclusive dressings. There are no clear cost differences between occlusive and nonocclusive dressings when treating venous leg ulcers.
Publication Types:
Keywords:
- Alginates
- Bandages
- Bandages, Hydrocolloid
- Diabetic Foot
- Humans
- Hydrogel
- Leg Ulcer
- Occlusive Dressings
- Odds Ratio
- Ointments
- Physical Examination
- Pressure Ulcer
- Varicose Ulcer
- Wound Healing
- methods
- hsrmtgs
Other ID:
UI: 102272012
From Meeting Abstracts