A Cochrane review 3 (abstract , review [Abstract]) [withdrawn from publication] included 42 studies. The main dressing types that were evaluated were hydrocolloids (n = 23), foams (n = 6), alginates (n = 4), hydrogel dressings (n = 6) and a group of miscellaneous dressings (n = 3). In none of the comparisons was there evidence that any one dressing type was better than others in terms of number of ulcers healed. Hydrocolloids are not more effective than simple low adherent dressings used beneath compression (9 trials; relative risk for healing with hydrocolloid 1.09 (95% CI 0.89 to 1.34)). For other comparisons there was insufficient evidence.
A technology assessment report 1 on modern dressings in the treatment of pressure ulcers and leg ulcers of vascular origin was abstracted in the Health Technology Assessment Database 2. Dressing therapy of chronic wounds remains empirical and there is little evidence to indicate which dressings are the most effective in their care. Methodological flaws and poor quality are common in the trials. There is some data that hydrocolloid dressings may increase the proportion of healed pressure ulcers compared with traditional saline-gauze dressings. There is no evidence that modern dressings are more effective than simple dressings (knitted viscose dressings or saline gauze) for the treatment of leg ulcers. Among modern dressings there is no evidence that any particular dressing type is more effective in healing pressure ulcers or leg ulcers.
Comment: The quality of evidence is downgraded by study quality (unclear allocation concealment), by inconsistency (heterogeneity in interventions and outcomes), and by imprecise results (limited study size for each comparison).
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