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Meta-Analysis
. 2020 Oct 27;17(21):7881.
doi: 10.3390/ijerph17217881.

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

Magdalena Sylwia Kamińska  1 , Anna Maria Cybulska  2 , Karolina Skonieczna-Żydecka  3 , Katarzyna Augustyniuk  2 , Elżbieta Grochans  2 , Beata Karakiewicz  4
Affiliations
Meta-Analysis

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

Magdalena Sylwia Kamińska et al. Int J Environ Res Public Health. .

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 (p = 0.839; Z = 0.203; CI 95%: 0.791-1.334). They were not associated with higher healing rates (p = 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 (p = 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, p = 0.465; t value = 1.198, p = 0.442; t value = 0.834, p = 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.

Keywords: dressings; meta-analysis; pressure ulcer; systematic review; wound healing.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
A flow diagram of the included and excluded studies.
Figure 2
Figure 2
(a) The effect size for the pressure ulcer healing rate when using hydrocolloid vs. alternative dressings. Q = 25.272, df (Q) = 7, p = 0.001, I squared = 72.301; (b) Funnel plot for pressure ulcer healing (RR) in the present meta-analysis.
Figure 3
Figure 3
(a) The effect size for the pressure ulcer healing rate (cm2/day) when using hydrocolloid vs. alternative dressings. Q = 3.588, df (Q) = 1, p = 0.166, I squared = 44.25. (b) Funnel plot for the pressure ulcer healing rate (SMD) in this meta-analysis.
Figure 4
Figure 4
(a) The effect size for adverse events when using hydrocolloids vs. controls. Q = 3.251, df (Q) = 4, p = 0.517, I squared = 0.0. (b) Funnel plot for adverse events (RR) in the present meta-analysis.
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