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)

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)

Various (meta-analysis)

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.

Dressing choice unimportant for leg ulcers is a sample topic from the EE+ POEM Archive.

To view other topics, please or purchase a subscription.

Evidence Central is an integrated web and mobile solution that helps clinicians quickly answer etiology, diagnosis, treatment, and prognosis questions using the latest evidence-based research. Learn more.


* When formatting your citation, note that all book, journal, and database titles should be italicized* 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 -