Xiangya School of Nursing, Central South University, Changsha, Hunan, China.
Xiangya Center for Evidence-Based Nursing Practice & Healthcare Innovation: A JBI Center of Excellence, Changsha, China.
BMJ Open. 2024 Aug 13;14(8):e077902. doi: 10.1136/bmjopen-2023-077902.
To evaluate the effects of silver and iodine dressings on healing time, healing rate, exudate amount, pain and anti-infective efficacy.
Systematic review and meta-analysis.
Databases including PubMed, Cochrane Library, Embase, Web of Science and CINAHL were surveyed up to May 2024.
Randomised controlled trials comparing silver and iodine dressings on wound healing in humans.
Evidence certainty was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation approach. Data extraction was done independently by two reviewers, with the risk of bias assessed using the Cochrane tool. Narrative synthesis was performed to evaluate the effects of silver and iodine dressings on healing time, healing rate, pain, exudate amount and anti-infective efficacy. Meta-analysis using Review Manager V.5.4 calculated standardised mean differences for healing time and relative risks for rate to quantify the impacts of the treatments.
17 studies (18 articles) were included. The meta-analysis indicated that silver dressings significantly reduced healing time compared with iodine dressings (SMD=-0.95, 95% CI -1.62 to -0.28, I=92%, p=0.005, moderate-quality evidence), with no significant difference in enhancing healing rate (RR=1.29, 95% CI 0.90 to 1.85, I=91%, p=0.16, low-quality evidence). Based on low-quality evidence, for exudate amount (3/17), 66.7% (2/3) of the studies favoured silver dressings over iodine in reducing exudate volume. For pain (7/17), 57.1% (4/7) of the studies reported no significant difference between silver and iodine dressings, while 42.9% (3/7) studies indicated superior pain relief with silver dressings. For anti-infective efficacy (11/13), 54.5% (6/11) of the studies showed equivalence between silver and iodine dressings, while 36.4% (4/11) suggested greater antibacterial efficacy for silver.
Silver dressings, demonstrating a comparable healing rate to iodine dressings, significantly reduce healing time, suggesting their potential as a superior adjunct in wound care.
CRD42020199602.
评估银和碘敷料在愈合时间、愈合率、渗出量、疼痛和抗感染疗效方面的效果。
系统评价和荟萃分析。
检索了 PubMed、Cochrane 图书馆、Embase、Web of Science 和 CINAHL 等数据库，截至 2024 年 5 月。
比较人类伤口愈合中银和碘敷料的随机对照试验。
使用推荐评估、发展和评估方法评估证据确定性。由两名评审员独立进行数据提取，使用 Cochrane 工具评估偏倚风险。使用 Review Manager V.5.4 进行叙述性综合评估银和碘敷料对愈合时间、愈合率、疼痛、渗出量和抗感染疗效的影响。荟萃分析计算了愈合时间的标准化均数差值和治疗效果的相对风险，以量化这些治疗的影响。
纳入 17 项研究（18 篇文章）。荟萃分析表明，与碘敷料相比，银敷料显著缩短了愈合时间（SMD=-0.95，95%CI-1.62 至-0.28，I=92%，p=0.005，中等质量证据），但对提高愈合率没有显著影响（RR=1.29，95%CI 0.90 至 1.85，I=91%，p=0.16，低质量证据）。基于低质量证据，对于渗出量（3/17），33.3%（1/3）的研究表明银敷料比碘敷料减少渗出量更优。对于疼痛（7/17），71.4%（5/7）的研究报告银敷料和碘敷料之间无显著差异，而 28.6%（7/24）的研究表明银敷料可更好地缓解疼痛。对于抗感染疗效（11/13），54.5%（6/11）的研究表明银敷料和碘敷料等效，而 36.4%（4/11）的研究表明银具有更强的抗菌效果。
与碘敷料相比，银敷料在愈合率相当的情况下，显著缩短了愈合时间，这表明其在伤口护理中可能具有更好的辅助作用。
PROSPERO 注册号：CRD42020199602。
