School of Nursing, Queen's University, Kingston, Ontario, Canada.
East London NHS Foundation Trust, London, UK.
Int Wound J. 2021 Oct;18(5):586-597. doi: 10.1111/iwj.13560. Epub 2021 Feb 8.
The aim of this study was to summarise the clinical evidence supporting almost 40 years of topical cadexomer iodine (CIOD) use in wound bed preparation by removing barriers to healing such as exudate, slough, bioburden, and infection and allowing chronic wound progression. A systematic review was conducted (Embase/PubMed, November 2020) to identify relevant comparative studies meeting inclusion criteria. Meta-analyses were performed using a fixed-effects (I < 50%) or random-effects model (I ≥ 50%) depending on statistical heterogeneity. Dichotomous outcomes were reported as relative risk (RR) and continuous outcomes as mean difference (MD), with 95% confidence intervals. In total, 436 publications were identified of which 13 were comparative trials including outcomes of interest. Significant reductions in exudate, pus/debris, slough, bioburden, and infection were reported in chronic wounds treated with CIOD, compared with standard of care (SOC). Meta-analyses highlighted the positive impact of CIOD on mean wound area reduction (MD = 2.35 cm , 95% CI = 0.34-4.36, P = .0219) after eight weeks treatment and overall wound healing events compared to SOC; wounds including venous leg ulcers, diabetic foot ulcers, and pressure ulcers treated with CIOD were more than twice as likely to heal than those receiving SOC (RR = 2.30, 95% CI = 1.54-3.45, P < .0001). This meta-analysis demonstrates the efficacy of CIOD on chronic wounds through removal of barriers to healing. CIOD should be considered in wound bed preparation and treatment protocols.
本研究旨在总结近 40 年来局部使用聚卡波非钙（CIOD）通过清除渗出物、坏死组织、生物负荷和感染等阻碍愈合的因素，以及允许慢性伤口进展，从而为伤口床准备提供临床证据。系统检索（Embase/PubMed，2020 年 11 月）以确定符合纳入标准的相关对照研究。使用固定效应（I < 50%）或随机效应模型（I ≥ 50%）进行荟萃分析，取决于统计异质性。二分类结局报告为相对风险（RR），连续结局报告为均数差（MD），并附有 95%置信区间。共确定了 436 篇文献，其中 13 篇为比较试验，包括感兴趣的结局。与标准护理（SOC）相比，CIOD 治疗的慢性伤口中渗出物、脓液/碎屑、坏死组织、生物负荷和感染明显减少。荟萃分析强调了 CIOD 在 8 周治疗后对平均伤口面积减少（MD = 2.35cm，95%CI = 0.34-4.36，P =.0219）和总体伤口愈合事件的积极影响与 SOC 相比；与接受 SOC 的伤口相比，CIOD 治疗的静脉性下肢溃疡、糖尿病足溃疡和压力性溃疡的伤口愈合率高出两倍以上（RR = 2.30，95%CI = 1.54-3.45，P < .0001）。这项荟萃分析通过清除愈合障碍，证明了 CIOD 对慢性伤口的疗效。CIOD 应考虑纳入伤口床准备和治疗方案。
