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水胶体敷料治疗成人压疮的有效性:系统评价和荟萃分析。

Effectiveness of Hydrocolloid Dressings for Treating Pressure Ulcers in Adult Patients: A Systematic Review and Meta-Analysis.

机构信息

Subdepartment of Long-Term Care, Department of Social Medicine, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, 48 Żołnierska St., 71-210 Szczecin, Poland.

Department of Nursing, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, 48 Żołnierska St., 71-210 Szczecin, Poland.

出版信息

Int J Environ Res Public Health. 2020 Oct 27;17(21):7881. doi: 10.3390/ijerph17217881.

Abstract

The aim of this study was to assess the effectiveness of hydrocolloid dressings in the treatment of grade I, II, III, and IV pressure ulcers in adult patients. We compared the therapeutic effects of hydrocolloids and alternative dressings in pressure ulcer treatment. We conducted a systematic review, using a literature search only in English, from database inception until 20 April 2020, to identify randomized trials comparing various types of dressings applied in the healing of pressure ulcers. The databases were PubMed, Embase, and Cumulative Index to Nursing and Allied Health Literature (CINAHL). The study selection was performed independently by two reviewers. Data were extracted based on the guidelines included in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol. The risk of bias in the included studies was assessed using a standardized critical appraisal instrument developed by the Cochrane Collaboration. Random-effect meta-analysis of data from three or more studies was performed using meta-analysis software (Comprehensive Meta-Analysis V3, Biostat, New Jersey, USA). A total of 1145 records were identified, of which 223 were qualified after further verification, of which eight were finally included in further analysis. Hydrocolloid dressings were not superior to control therapeutics ( = 0.839; Z = 0.203; CI 95%: 0.791-1.334). They were not associated with higher healing rates ( = 0.718; Z = 0.361; OR: 0.067; CI 95%: 0.297-0.431), nor did they decrease the incidence of adverse events compared with control therapeutics ( = 0.300; Z = -1.036; OR: 0.067; CI 95%: 0.394-1.333). In the above cases, Egger's test also did not indicate publication bias (t value = 0.779, = 0.465; t value = 1.198, = 0.442; t value = 0.834, = 0.465, respectively). The present meta-analysis shows that hydrocolloid dressings are not significantly better than alternative ones in the healing of pressure ulcers in adult patients.

摘要

本研究旨在评估水胶体敷料在治疗成人 I 、 II 、 III 和 IV 期压力性溃疡中的疗效。我们比较了水胶体敷料和其他敷料在治疗压力性溃疡中的治疗效果。我们进行了一项系统评价,仅使用英文文献,从数据库建立到 2020 年 4 月 20 日,以确定比较各种类型敷料在治疗压力性溃疡中的愈合效果的随机试验。检索的数据库包括 PubMed 、 Embase 和 Cumulative Index to Nursing and Allied Health Literature (CINAHL )。研究选择由两名独立的评审员进行。根据《系统评价和荟萃分析首选报告项目》(PRISMA )协议中的指南提取数据。使用 Cochrane 协作开发的标准化评价工具评估纳入研究的偏倚风险。使用荟萃分析软件( Comprehensive Meta-Analysis V3 , Biostat , New Jersey , USA )对来自 3 项或更多研究的数据进行随机效应荟萃分析。共确定了 1145 条记录,进一步验证后有 223 条符合条件,最终有 8 条纳入进一步分析。水胶体敷料并不优于对照组治疗( = 0.839 ; Z = 0.203 ; 95%CI : 0.791-1.334 )。它们与更高的愈合率无关( = 0.718 ; Z = 0.361 ; OR : 0.067 ; 95%CI : 0.297-0.431 ),与对照组治疗相比,也不会降低不良事件的发生率( = 0.300 ; Z = -1.036 ; OR : 0.067 ; 95%CI : 0.394-1.333 )。在上述情况下,Egger 检验也未表明存在发表偏倚( t 值 = 0.779 , = 0.465 ; t 值 = 1.198 , = 0.442 ; t 值 = 0.834 , = 0.465 )。本荟萃分析表明,水胶体敷料在治疗成人压力性溃疡方面并不明显优于其他敷料。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f163/7662705/1d06f66bd5ae/ijerph-17-07881-g001.jpg

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