Alginate dressings for healing diabetic foot ulcers

  • Review
  • Intervention

Authors


Abstract

Background

Foot ulcers in people with diabetes mellitus are a common and serious global health issue. Dressings form a key part of ulcer treatment, with clinicians and patients having many different types to choose from including alginate dressings. A clear and current overview of current evidence is required to facilitate decision-making regarding dressing use.

Objectives

To compare the effects of alginate wound dressings with no wound dressing or alternative dressings on the healing of foot ulcers in people with diabetes mellitus.

Search methods

For this first update, in April 2013, we searched the following databases the Cochrane Wounds Group Specialised Register; The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library); Ovid MEDLINE; Ovid MEDLINE (In-Process & Other Non-Indexed Citations); Ovid EMBASE; and EBSCO CINAHL. There were no restrictions based on language or date of publication.

Selection criteria

Published or unpublished randomised controlled trials (RCTs) that have compared the effects on ulcer healing of alginate dressings with alternative wound dressings or no dressing in the treatment of foot ulcers in people with diabetes.

Data collection and analysis

Two review authors independently performed study selection, risk of bias assessment and data extraction.

Main results

We included six studies (375 participants) in this review; these compared alginate dressings with basic wound contact dressings, foam dressings and a silver-containing, fibrous-hydrocolloid dressing. Meta analysis of two studies found no statistically significant difference between alginate dressings and basic wound contact dressings: risk ratio (RR) 1.09 (95% CI 0.66 to 1.80). Pooled data from two studies comparing alginate dressings with foam dressings found no statistically significant difference in ulcer healing (RR 0.67, 95% CI 0.41 to 1.08). There was no statistically significant difference in the number of diabetic foot ulcers healed when an anti-microbial (silver) hydrocolloid dressing was compared with a standard alginate dressing (RR 1.40, 95% CI 0.79 to 2.47). All studies had short follow-up times (six to 12 weeks), and small sample sizes.

Authors' conclusions

Currently there is no research evidence to suggest that alginate wound dressings are more effective in healing foot ulcers in people with diabetes than other types of dressing however many trials in this field are very small. 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.

Plain language summary

Alginate dressings for healing foot ulcers in people with diabetes mellitus

Diabetes mellitus, a condition which leads to high blood glucose concentrations, is a common condition with around 2.8 million people affected in the UK (approximately 4.3% of the population). Wound dressings are widely used to treat foot ulcers in people with diabetes. There are many types of dressings that can be used, which also vary considerably in cost. This review (six studies involving a total of 375 participants) identified no research evidence to suggest that alginate wound dressings are more effective in healing diabetic foot ulcers than other types of dressing. More, better quality research is needed.

Ringkasan bahasa mudah

Pembalut alginat untuk penyembuhan ulser kaki dalam kalangan orang dengan diabetes mellitus

Diabetes mellitus, satu keadaan yang membawa kepada kepekatan glukosa darah tinggi, adalah keadaan lazim dengan kira-kira 2.8 juta orang yang terjejas di UK (kira-kira 4.3% daripada penduduk). Pembalut luka digunakan secara meluas untuk merawat ulser kaki dalam kalangan orang dengan diabetes. Terdapat banyak jenis pembalut yang boleh digunakan, yang juga berbeza dari segi kos. Ulasan ini (6 kajian yang melibatkan seramai 375 peserta) mengenal pasti bahawa tiada bukti penyelidikan yang menunjukkan bahawa pembalut luka alginat lebih berkesan dalam penyembuhan ulser kaki diabetik berbanding dengan pembalut jenis lain. Penyelidikan yang lebih banyak dan berkualiti diperlukan.

Catatan terjemahan

Diterjemahkan oleh Khaw Loke Tim (International Medical University). Disunting oleh Noorliza Mastura Ismail (Kolej Perubatan Melaka-Manipal). Untuk sebarang pertanyaan sila hubungi LokeTimKhaw@imu.edu.my.