7.4Dressings for wound healing by secondary intention

Bibliographic detailsStudy type and evidence levelNo. of participantsParticipants characteristicsIntervention and comparisonOutcome measures, follow-up and effect sizeComments
Cannavo 1998215
Australia
RCT

EL = 1−
Total no. of patients

n = 36
Randomised in three arms:

Group 1 n = 13
Group 2 n = 10
Group 3 n = 13
Adult patients with surgical abdominal wound

Exclusion criteria:
Less than 18 years old, known allergies to the dressings agents and no inform consent.
Group1
Alginate dressing

Group2
Gauze dressing with sodium hypochlorite (0.05%) then normal saline (0.09%) when wound granulating, plus a combine dressing pad

Group3
A combine dressing pad (cotton wool and gauze)

Comparisons
C1 Alginate dressing vs gauze dressing with sodium hypochlorite

C2 Combine dressing pad vs gauze dressing with sodium hypochlorite
Follow-up
Until healing end-point (up to 38 days)
Outcome
Healing rate= wound size reduction per day (mean in surface: cm2/day and volume: cm3/day)

Effect size
Wound reduction
Group1
0.55 cm2/day
0.57 cm3/day
Group2
0.51 cm2/day
0.50 cm3/day
Group3
0.79 cm2/day
0.90 cm3/day

Difference Group 2 from Group 1 (cm2/day and cm3/day)
−0.03, 95% CI −0.81 to 0.41 P = 0.08
−0.07, 95% CI −0.53 to 0.38
P = 0.32
Difference Group 2 from Group 3 (cm2/day and cm3/day)
−0.04, 95% CI −0.17 to 0.09 P = 0.53
−0.07, 95% CI −0.20 to 0.
P = 0.30
Funding
Division of Surgery, St George Hospital, Kogarah

Comments
39 patients recruited for the trial but three withdraw before the start. Six further withdrawals before the end of the study.
Macfie 1980216
UK
RCT

EL = 1−
Total no. of patients

n = 50
Randomised in two arms:

group1 n = 25

group2 n = 25
Patients with open perineal wounds after abdominal perineal excision of the rectum

Exclusion criteria:
n.s.
group1
Silicone foam elastomer +catalyst
Group2
Ribbon gauze soaked in mercuric chloride antiseptic solution

Comparison
Silicone foam
vs
gauze with mercuric antiseptic solution
Follow-up
Until complete healing

Outcome
Healing (time to complete epithelialisation days and time to a dry dressing, mean ± )

Effect size
Time to FE
group1 60.3 ± 3.0
group2 69.5 ± 7.3 (P < 0.05)
Time to a DD
group1 47.5 ± 3.1
group2 62.6 ± 6.3 (P < 0.05)
Funding
Foam dressings supplied by Dow Corning Ltd
Comments
Unclear if patients who died before complete healing (3 in each group) or those whose wounds failed to heal (2 in each group) were included in the analysis.
When no cavity remained a dry dressing was applied as the sole dressing in both groups.
Dawson 1992218
UK
RCT

EL = 1−
Total no. of patients

n = 34
randomised in two arms:
group1 n = 18

group2 n = 16
Patients over 16 y.o. with incision and drainage of abscess

Exclusion criteria:
n.s.
group1
Gauze soaked in saline
Group2
Calcium alginate dressing

Comparison
Gauze with saline
vs
alginate dressing
Follow-up
Outcomes assessed at 2 weeks. If wound not healed final follow-up at 4 weeks

Outcome
Complete healing at 2 weeks

Effect size
Complete healing
group1 12 out of 16 (75%)
group2 13 out of 18 (72%)
P>0.05
Funding
BritCair UK provided Alginate dressings

Comments
No sufficient baseline details reported
Meyer 1997217
Germany
RCT

EL = 1−
Total no. of patients

n = 43 randomised in two arms:
group1 n = 22

group2 n = 21
Patients with a secondary healing wound after laparotomy or surgical incision of an abscess
Exclusion criteria:
Allergic reactions to the products used, diabetes, immunodeficiency, steroids, radiotherapy, chemotherapy or wounds consisting of a big subcutaneous cavity
group1
Moist cotton gauze

group2
Polyurethane foam with active particles

Comparison
Moist gauze vs foam
Follow-up
4 weeks

Outcome
Wound size reduction
Number of wounds completely healed at week 4

Effect size
Wound size reduction
group1 50.1%
group2 75.6%

Number of wounds healed
group1 4 out of 22
group2 10 out 21
Funding
n.s.
Comments
The statistical used to analysed the data was not reported

From: Evidence tables

Cover of Surgical Site Infection
Surgical Site Infection: Prevention and Treatment of Surgical Site Infection.
NICE Clinical Guidelines, No. 74.
National Collaborating Centre for Women's and Children's Health (UK).
London: RCOG Press; 2008 Oct.
Copyright © 2008, National Collaborating Centre for Women’s and Children’s Health.

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