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Evidence summaries

Dressings and Topical Agents for Treating Pressure Ulcers

There is insufficient evidence to determine which dressings or topical agents are the most likely to heal pressure ulcers. Level of evidence: "D"

The level of evidence is downgraded by imprecise results and indirectness (a network meta-analysis).

Summary

A Cochrane review [Abstract] 1 included 51 studies with a total of 2947 subjects. A network meta-analysis (NMA) was carried out in a network of linked interventions for the sole outcome of probability of complete healing. The network included 21 different interventions (13 dressings, 6 topical agents and 2 supplementary linking interventions) and was informed by 39 studies in 2127 participants, of whom 783 had completely healed wounds.

It is not clear whether regimens involving protease-modulating dressings increase the probability of pressure ulcer healing compared with saline gauze (RR 1.65, 95% CI 0.92 to 2.94). This risk ratio of 1.65 corresponds to an absolute difference of 102 more people healed with protease modulating dressings per 1000 people treated than with saline gauze alone (95% CI 13 fewer to 302 more). It is unclear whether the following interventions increase the probability of healing compared with saline gauze (low-certainty evidence): collagenase ointment (RR 2.12, 95% CI 1.06 to 4.22); foam dressings (RR 1.52, 95% CI 1.03 to 2.26); basic wound contact dressings (RR 1.30, 95% CI 0.65 to 2.58) and polyvinylpyrrolidone plus zinc oxide (RR 1.31, 95% CI 0.37 to 4.62).

Clinical comments

Note

Date of latest search:

References

  • Westby MJ, Dumville JC, Soares MO et al. Dressings and topical agents for treating pressure ulcers. Cochrane Database Syst Rev 2017;(6):CD011947. [PubMed]

Primary/Secondary Keywords