Table DSummary of the comparative benefits of advanced wound dressings in terms of wound healing

Comparison (Number of Included Studies)*Strength of EvidenceConclusions
Hydrocolloids vs. compression (3)LowHydrocolloid dressings were not more effective than compression therapy alone in terms of the proportion of chronic venous ulcers healed. The results from the three studies addressing this comparison were imprecise and subject to some bias.
Hydrocolloids vs. other dressings (4)InsufficientWe were unable to draw a conclusion.
Transparent films vs. compression (1)InsufficientWe were unable to draw a conclusion.
Transparent films vs. other dressings (1)InsufficientWe were unable to draw a conclusion.
Alginate dressings vs. compression (1)InsufficientWe were unable to draw a conclusion.
Alginate dressings vs. alginate dressings (2)InsufficientWe were unable to draw a conclusion.
Alginate dressings vs. other dressings (1)InsufficientWe were unable to draw a conclusion.
Foam dressings vs. foam dressings (3)InsufficientWe were unable to draw a conclusion.
Collagen dressings vs. compression (1)LowCollagen dressings healed a greater proportion of ulcers than compression alone.
Acellular human skin equivalent dressings vs. compression (3)InsufficientWe were unable to draw a conclusion.
Cellular (cryo-preserved human fibroblast-derived dermal substitute) vs. compression (2)InsufficientWe are unable to draw a conclusion.
Cellular human skin equivalents (allogenic bilayered cultured HSE) vs. compression (1)ModerateStudies of cellular human skin equivalent dressings in patients with chronic venous ulcers showed a higher proportion of ulcers healed and more rapid healing, especially those that had failed previous therapy and were present for over 1 year.
Cellular (autologous keratinocytes in a fibrin sealant) vs. compression (1)LowAutologous keratinocytes in fibrin sealant healed a greater proportion of ulcers and achieved a shorter median time to complete wound closure versus compression.
Cellular human skin equivalent dressings vs. other dressings (2)InsufficientWe were unable to draw a conclusion.
Antimicrobial dressings vs. compression (2)InsufficientWe were unable to draw a conclusion.
Antimicrobial dressings vs. antimicrobial dressings (2)InsufficientWe were unable to draw a conclusion.
Antimicrobial containing dressings vs. other types of dressings (4)ModerateSome antimicrobial dressings improved wound area reduction by 20 percent or more as compared with other nonantimicrobial dressings. However, silver dressings did not improve wound healing as compared with nonsilver dressings.
*

The strength of evidence for all comparisons not listed here were graded as insufficient because we did not find any studies addressing them or because we were unable to draw a conclusion from the evidence.

We defined the strength of evidence as follows: High = High confidence that the evidence reflects the true effect. Further research is unlikely to change our confidence in the estimate of the effect. Moderate = Moderate confidence that the evidence reflects the true effect. Further research may change our confidence in the estimate of the effect and may change the estimate. Low = Low confidence that the evidence reflects the true effect. Further research is likely to change our confidence in the estimate of the effect and is likely to change the estimate. Insufficient = Evidence is unavailable or does not permit a conclusion.

The strength of evidence for all comparisons not listed here were graded as insufficient because we did not find any studies addressing them or because we were unable to draw a conclusion from the evidence.

We defined the strength of evidence as follows: High = High confidence that the evidence reflects the true effect. Further research is unlikely to change our confidence in the estimate of the effect. Moderate = Moderate confidence that the evidence reflects the true effect. Further research may change our confidence in the estimate of the effect and may change the estimate. Low = Low confidence that the evidence reflects the true effect. Further research is likely to change our confidence in the estimate of the effect and is likely to change the estimate. Insufficient = Evidence is unavailable or does not permit a conclusion.

From: Executive Summary

Cover of Chronic Venous Ulcers: A Comparative Effectiveness Review of Treatment Modalities
Chronic Venous Ulcers: A Comparative Effectiveness Review of Treatment Modalities [Internet].
Comparative Effectiveness Reviews, No. 127.
Zenilman J, Valle MF, Malas MB, et al.

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