Dressing choice unimportant for leg ulcers
Clinical Question
Which dressing is best when used under a pressure bandage for venous leg ulcers?
Bottom Line
In this meta-analysis, no type of product -- hydrocolloid, foam, hydrogel, or alginate -- was found to be better than a low-adherent dressing or better than one another with regard to healing. Cost, ease of use, and pain on application or removal based on clinical experience can be used to guide product choice. (LOE = 1a)
Reference
Palfreyman S, Nelson EA, Michaels JA. Dressings for venous leg ulcers: systematic review and meta-analysis. BMJ 2007;335:244. [PMID:17631512]
Study Design
Meta-analysis (randomized controlled trials)
Funding
Government
Setting
Various (meta-analysis)
Synopsis
To determine which is the best among the numerous dressings to cover a venous leg ulcer under a compression bandage (eg, Unna boot), these researchers searched 4 databases, examined conference proceedings, checked citations, and contacted experts and dressing manufacturers. Two reviewers independently assessed the trials, identifying 42 studies enrolling a total of almost 1000 patients. They did not include studies of diabetic or arterial ulcers. All of the studies were randomized. Allocation concealment was unclear for most to them, as was the masking of the outcome assessor. These design erors could result in an overestimate of benefit of one treatment or another. Studies compared various dressing types and products within specific types, with no studies demonstrating a benefit of one dressing over another or one product over another in terms of healing. As a result, choice of dressing can be based on other factors, such as cost, ease of use, and pain associated with their use, areas that have been poorly studied to date.
Citation
Barry, Henry, et al., editors. "Dressing Choice Unimportant for Leg Ulcers." EE+ POEM Archive, John Wiley & Sons, 2024. Evidence Central, evidence.unboundmedicine.com/evidence/view/infoPOEMs/426495/all/Dressing_choice_unimportant_for_leg_ulcers.
Dressing choice unimportant for leg ulcers. In: Barry HH, Ebell MHM, Shaughnessy AFA, et al, eds. EE+ POEM Archive. John Wiley & Sons; 2024. https://evidence.unboundmedicine.com/evidence/view/infoPOEMs/426495/all/Dressing_choice_unimportant_for_leg_ulcers. Accessed November 13, 2024.
Dressing choice unimportant for leg ulcers. (2024). In Barry, H., Ebell, M. H., Shaughnessy, A. F., & Slawson, D. C. (Eds.), EE+ POEM Archive. John Wiley & Sons. https://evidence.unboundmedicine.com/evidence/view/infoPOEMs/426495/all/Dressing_choice_unimportant_for_leg_ulcers
Dressing Choice Unimportant for Leg Ulcers [Internet]. In: Barry HH, Ebell MHM, Shaughnessy AFA, Slawson DCD, editors. EE+ POEM Archive. John Wiley & Sons; 2024. [cited 2024 November 13]. Available from: https://evidence.unboundmedicine.com/evidence/view/infoPOEMs/426495/all/Dressing_choice_unimportant_for_leg_ulcers.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC
T1 - Dressing choice unimportant for leg ulcers
ID - 426495
ED - Barry,Henry,
ED - Ebell,Mark H,
ED - Shaughnessy,Allen F,
ED - Slawson,David C,
BT - EE+ POEM Archive
UR - https://evidence.unboundmedicine.com/evidence/view/infoPOEMs/426495/all/Dressing_choice_unimportant_for_leg_ulcers
PB - John Wiley & Sons
DB - Evidence Central
DP - Unbound Medicine
ER -