A Cochrane review [Abstract] 1 included 4 studies with a total of 164 subjects. One RCT in women with superficial breast lesions compared 6% miltefosine solution with placebo and found that miltefosine delayed tumour progression. Time to treatment failure was longer in the miltefosine group (median 56 days) than in the placebo group (median 21 days, p = 0.007). A second trial compared topical metronidazole with placebo and found that metronidazole reduced malodour, but the results up to the point of cross-over were not statistically significant. A third trial compared the effect of foam dressings containing silver to foam dressings without silver and found that more patients experienced decreased malodour in the foam with silver group than in the foam alone group (p = 0.049). The fourth trial compared the effect of manuka honey-coated dressings with nanocrystalline silver-coated dressings and found no statistically significant difference with regard to exudate, malodour and wound pain.
Comment: The quality of evidence is downgraded by study quality (unclear allocation concealment) and by imprecise results (few patients and wide confidence intervals).
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