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Meta-Analysis
. 2015 Feb 17;2015(2):CD011226.
doi: 10.1002/14651858.CD011226.pub2.

Hydrogel dressings for treating pressure ulcers

Jo C Dumville  1 , Nikki Stubbs, Samantha J Keogh, Rachel M Walker, Zhenmi Liu
Affiliations
Meta-Analysis

Hydrogel dressings for treating pressure ulcers

Jo C Dumville et al. Cochrane Database Syst Rev. .

Abstract

Background: Pressure ulcers, also known as bedsores, decubitus ulcers and pressure injuries, are localised areas of injury to the skin or the underlying tissue, or both. Dressings are widely used to treat pressure ulcers and there are many different dressing options including hydrogel dressings. A clear and current overview of the current evidence is required to facilitate decision-making regarding dressing use for the treatment of pressure ulcers.

Objectives: To assess the effects of hydrogel dressings on the healing of pressure ulcers in any care setting.

Search methods: We searched the following databases: the Cochrane Wounds Group Specialised Register (searched 19 June 2014); The Cochrane Central Register of Controlled Trials (CENTRAL; 2014, Issue 5); Ovid MEDLINE (1946 to June Week 2 2014); Ovid MEDLINE (In-Process & Other Non-Indexed Citations, 23 June 2014); Ovid EMBASE (1974 to 20 June 2014); and EBSCO CINAHL (1982 to 18 June 2014). There were no restrictions based on language or date of publication.

Selection criteria: Published or unpublished randomised controlled trials (RCTs) comparing the effects of hydrogel dressings with alternative wound dressings or no dressing in the treatment of pressure ulcers (stage II or above).

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

Main results: We included eleven studies (523 participants) in this review. Ten studies had two arms and one had three arms that were all relevant to this review. Three studies compared a hydrogel dressing with a basic wound contact dressing; three studies compared a hydrogel dressing with a hydrocolloid dressing; three studies compared a hydrogel dressing with another hydrogel dressing; one study compared a hydrogel dressing with a foam dressing; one study compared a hydrogel dressing with a dextranomer paste dressing and one study compared a hydrogel dressing with a topical treatment (collagenase). Limited data were available for analyses in this review: we conducted no meta-analyses. Where data were available there was no evidence of a difference between hydrogel and alternative treatments in terms of complete wound healing or adverse events. One small study reported that using hydrogel dressings was, on average, less costly than hydrocolloid dressings, but this estimate was imprecise and its methodology was not clear. All included studies were small, had short follow-up times and were at unclear risk of bias.

Authors' conclusions: It is not clear if hydrogel dressings are more or less effective than other treatments in healing pressure ulcers or if different hydrogels have different effects, Most trials in this field are very small and poorly reported so that risk of bias is unclear.

PubMed Disclaimer

Conflict of interest statement

Jo C Dumville: nothing to declare. Nikki Stubbs: funding from pharmaceutical companies supports training and education events in the service and payments have been received by the author for non product‐related educational sessions. These have been unrelated to the subject matter of the systematic review and have never been in support or in pursuit of the promotion of products. Samantha J Keogh: nothing to declare. Rachel M Walker: is currently employed by the National Health and Medical Research Council's Centre of Research Excellence in Nursing (NCREN), Griffith University Australia. Skin integrity including pressure ulcers is a research focus of NCREN. Zhenmi Liu: nothing to declare.

Figures

1
1
Study flow diagram
2
2
Risk of bias summary: review authors' judgements about each risk of bias item for each included study
3
3
Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies
1.1
1.1. Analysis
Comparison 1 Hydrogel dressings compared with basic wound contact dressings, Outcome 1 Number of wounds healed.
1.2
1.2. Analysis
Comparison 1 Hydrogel dressings compared with basic wound contact dressings, Outcome 2 Change in wound size (mean volume relative to baseline volume).
1.3
1.3. Analysis
Comparison 1 Hydrogel dressings compared with basic wound contact dressings, Outcome 3 Change in wound size (mean reduction in size per week).
2.1
2.1. Analysis
Comparison 2 Hydrogel dressings compared with hydrocolloid dressings, Outcome 1 Complete wound healing.
2.2
2.2. Analysis
Comparison 2 Hydrogel dressings compared with hydrocolloid dressings, Outcome 2 Change in wound size: reduction in wound size per week.
2.3
2.3. Analysis
Comparison 2 Hydrogel dressings compared with hydrocolloid dressings, Outcome 3 Costs.
3.1
3.1. Analysis
Comparison 3 One brand of hydrogel dressings compared with another hydrogel dressing, Outcome 1 Wound infection.
3.2
3.2. Analysis
Comparison 3 One brand of hydrogel dressings compared with another hydrogel dressing, Outcome 2 Adverse events: wound pain at end of study.
3.3
3.3. Analysis
Comparison 3 One brand of hydrogel dressings compared with another hydrogel dressing, Outcome 3 Adverse events: no pain on dressing removal.
See this image and copyright information in PMC

Update of

  • doi: 10.1002/14651858.CD011226

References

References to studies included in this review

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