Dumville Jo C, Deshpande Sohan, O'Meara Susan, Speak Katharine
Department of Health Sciences, University of York, York, UK.
Cochrane Database Syst Rev. 2012 Feb 15(2):CD009099. doi: 10.1002/14651858.CD009099.pub2.
Foot ulcers in people with diabetes are a prevalent and serious global health issue. Wound dressings are regarded as important components of ulcer treatment, with clinicians and patients having many different types to choose from including hydrocolloid dressings. There is a range of different hydrocolloids available including fibrous-hydrocolloid and hydrocolloid (matrix) dressings. A clear and current overview of current evidence is required to facilitate decision-making regarding dressing use.
To compare the effects of hydrocolloid wound dressings with no dressing or alternative dressings on the healing of foot ulcers in people with diabetes.
We searched The Cochrane Wounds Group Specialised Register (searched 4 January 2012); The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2011, Issue 4); Ovid MEDLINE (1950 to December Week 3 2011); Ovid MEDLINE (In-Process & Other Non-Indexed Citations, January 03, 2012); Ovid EMBASE (1980 to 2011 Week 52); and EBSCO CINAHL (1982 to 30 December 2011). There were no restrictions based on language or date of publication.
Published or unpublished randomised controlled trials (RCTs) that have compared the effects on ulcer healing of hydrocolloid with alternative wound dressings or no dressing in the treatment of foot ulcers in people with diabetes.
Two review authors independently performed study selection, risk of bias assessment and data extraction.
We included four studies (511 participants) in the review: these compared hydrocolloids with basic wound contact dressings, foam dressings and alginate dressings. Meta-analysis of two studies indicated no statistically significant difference in ulcer healing between fibrous-hydrocolloids and basic wound contact dressings: risk ratio 1.01 (95% CI 0.74 to 1.38). One of these studies found that a basic wound contact dressing was more cost-effective than a fibrous-hydrocolloid dressing. One study compared a hydrocolloid-matrix dressing with a foam dressing and found no statistically significant difference in the number of ulcers healed. There was no statistically significant difference in healing between an antimicrobial (silver) fibrous-hydrocolloid dressing and standard alginate dressing; or an antimicrobial dressing (iodine-impregnated) and a standard fibrous hydrocolloid dressing.
AUTHORS' CONCLUSIONS: Currently there is no research evidence to suggest that any type of hydrocolloid wound dressing is more effective in healing diabetic foot ulcers than other types of dressing. Decision makers may wish to consider aspects such as dressing cost and the wound management properties offered by each dressing type e.g. exudate management.
糖尿病患者足部溃疡是一个普遍且严重的全球性健康问题。伤口敷料被视为溃疡治疗的重要组成部分，临床医生和患者有多种不同类型可供选择，包括水胶体敷料。有一系列不同的水胶体可供使用，包括纤维 - 水胶体和水胶体（基质）敷料。需要一份清晰且最新的现有证据综述，以促进关于敷料使用的决策。
比较水胶体伤口敷料与不使用敷料或其他替代敷料对糖尿病患者足部溃疡愈合的影响。
我们检索了Cochrane伤口小组专业注册库（检索日期为2012年1月4日）；Cochrane对照试验中心注册库（CENTRAL）（Cochrane图书馆2011年第4期）；Ovid MEDLINE（1950年至2011年12月第3周）；Ovid MEDLINE（在研及其他未索引的文献，2012年1月3日）；Ovid EMBASE（1980年至2011年第52周）；以及EBSCO CINAHL（1982年至2011年12月30日）。不基于语言或出版日期进行限制。
已发表或未发表的随机对照试验（RCT），这些试验比较了水胶体与替代伤口敷料或不使用敷料对糖尿病患者足部溃疡治疗中溃疡愈合的影响。
两位综述作者独立进行研究选择、偏倚风险评估和数据提取。
我们在综述中纳入了四项研究（511名参与者）：这些研究比较了水胶体与基本伤口接触敷料、泡沫敷料和藻酸盐敷料。两项研究的荟萃分析表明，纤维 - 水胶体与基本伤口接触敷料在溃疡愈合方面无统计学显著差异：风险比为1.01（95%置信区间0.74至1.38）。其中一项研究发现，基本伤口接触敷料比纤维 - 水胶体敷料更具成本效益。一项研究比较了水胶体基质敷料与泡沫敷料，发现愈合溃疡的数量无统计学显著差异。抗菌（含银）纤维 - 水胶体敷料与标准藻酸盐敷料之间；或抗菌敷料（含碘）与标准纤维水胶体敷料之间在愈合方面无统计学显著差异。
目前没有研究证据表明任何类型的水胶体伤口敷料在愈合糖尿病足溃疡方面比其他类型的敷料更有效。决策者可能希望考虑诸如敷料成本以及每种敷料类型所提供的伤口管理特性（如渗出液管理）等方面。
