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银敷料治疗糖尿病足溃疡的疗效:系统评价和荟萃分析。

Effectiveness of silver dressings in the treatment of diabetic foot ulcers: a systematic review and meta-analysis.

机构信息

School of Nursing, Sun Yat-sen University, Guangzhou, China.

Emergency Department, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.

出版信息

J Wound Care. 2022 Nov 2;31(11):979-986. doi: 10.12968/jowc.2022.31.11.979.

Abstract

OBJECTIVE

Silver dressings have been used in the treatment of diabetic foot ulcers (DFUs). However, meta-analyses examining their effectiveness is lacking. Therefore, this meta-analysis evaluates the effectiveness of silver dressings on DFU healing.

METHOD

Various databases were searched for randomised controlled trials (RCTs) of silver dressing applied to DFUs.

RESULTS

A total of seven studies involving 650 patients were identified for inclusion in the meta-analysis. The odds ratio (OR) for silver dressing improving wound healing rate, complete healing time, ulcer-related in-hospital time and infection resolution rate were: 4.02 (95% confidence interval [CI]: 2.25-7.17; p<0.01); 2.81 (95% CI: -3.33--2.29; p<0.01); 12.13 (95% CI:-20.64--3.62; p<0.01); and 7.36 (95% CI: 1.58-34.22; p=0.01), respectively. The OR on ulcer area reduction was 8.60 (95% CI:-8.93-26.12; p=0.34) indicating no significant effect.

CONCLUSION

The results of this meta-analysis showed that silver dressings enhance DFU healing rate, shorten the time to complete healing, shorten in-hospital duration, and improve infection resolution rate, while having no significant effect on reduction of ulcer area. Large-scale, multicentre, rigorously designed RCTs are recommended for future investigation to justify the beneficial effects of silver dressings on DFU healing.

摘要

目的

银敷料已被用于治疗糖尿病足溃疡(DFU)。然而,缺乏关于其疗效的荟萃分析。因此,本荟萃分析评估了银敷料对 DFU 愈合的效果。

方法

检索了各种数据库,以查找应用于 DFU 的银敷料的随机对照试验(RCT)。

结果

共确定了 7 项纳入荟萃分析的研究,涉及 650 名患者。银敷料改善创面愈合率、完全愈合时间、溃疡相关住院时间和感染缓解率的优势比(OR)分别为:4.02(95%置信区间[CI]:2.25-7.17;p<0.01);2.81(95%CI:-3.33--2.29;p<0.01);12.13(95%CI:-20.64--3.62;p<0.01);和 7.36(95%CI:1.58-34.22;p=0.01)。溃疡面积减少的 OR 为 8.60(95%CI:-8.93-26.12;p=0.34),表明无显著影响。

结论

本荟萃分析结果表明,银敷料可提高 DFU 的愈合率,缩短完全愈合时间,缩短住院时间,提高感染缓解率,而对溃疡面积的减少无显著影响。建议进行大规模、多中心、严格设计的 RCT 以验证银敷料对 DFU 愈合的有益效果。

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