A Cochrane review [Abstract] 1 included 5 small poor quality studies with a total of 159 subjects. All studies were conducted prior to 1990 and compared treatments for infected surgical wounds reporting time required to achieve a clean wound bed (complete debridement). Four of the trials compared the effectiveness of dextranomer beads or paste with other products (different comparator in each trial) to achieve complete debridement. One trial compared an enzymatic agent (streptokinase/streptodornase) with saline-soaked dressings. The common outcome for the five included trials was time to a clean wound bed for infected post surgical wounds. No trials were identified that compared debridement with no debridement of surgical wounds. Three out of the four trials comparing dextranomer with other products reported shorter time to a clean wound bed for dextranomer. The trial comparing enzymatic debridement with saline-soaked dressings reported that the enzyme-treated wounds were cleaned more quickly.
Comment: The quality of evidence is downgraded by imprecise results (limited study size for each comparison), by serious limitations in study quality and by indirectness (old trials, the studied methods not widely available anymore).
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