Effects of Nine Different Dressings in the Treatment of Diabetic Foot: A Network Meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

 HOUYu-ying ¹ ^# ,  ZHANGZhi-gang ² ^# , ZHANGJun ³ , ZHANGJu-xia ⁴ , WANGBo ⁵ , YANGAi-ling ⁶ , TIANJin-hui ⁷

1. The First Clinical Medical College of Lanzhou University, Lanzhou 730000, China;
2. Department of Intensive Care Unit, The First Hospital of Lanzhou University, Lanzhou 730000, China;
3. School of Nursing, Gansu University of Traditional Chinese Medicine, Lanzhou 730000, China;
4. Department of Nursing, Gansu Provincial Hostipal, Lanzhou 730000, China;
5. Department of Nursing, Rehabilitation Hospital of Gansu Province, Lanzhou 730000, China;
6. Department of Nursing, Lanzhou University Second Hospital, Lanzhou 730000, China;
7. Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China;

Corresponding?author：

ZHANGZhi-gang, Email: zzg3444@163.com

Keywords：

Dressing; Diabetic foot; Randomized control trial; Network meta-analysis

DOI：

10.7507/1672-2531.20160196

Video：

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Objective To systematically evaluate the effects of nine different dressings in the treatment of diabetic foot (DF). Methods Databases including PubMed, The Cochrane Library (Issue 2, 2016), Web of Science, EMbase, CBM, CNKI and WanFang Data were searched to collect randomized control trials (RCTs) about the effects of dressings for the DF from inception to April 2016. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then network meta-analysis was performed using WinBugs 1.4.3 and Stata 13.0 softwares. Results A total of 29 RCTs involving 2 393 patients were included. The network meta-analysis showed that silver ion was superior to alginate, hydrogel, honey, sterile gauze and povidone-iodine gauze; Alginate was superior to sterile gauze and povidone-iodine gauze; Hydrogel was superior to povidone-iodine gauze; Honey was superior to sterile gauze and povidone-iodine gauze; Foam was superior to silver ion, alginate, hydrogel, honey, sterile gauze, povidone-iodine gauze and antibacterials gauze; Chitosan was superior to hydrogel, sterile gauze and povidone-iodine gauze; Antibacterials gauze was superior to sterile gauze and povidone-iodine gauze. All of the differences were statistically significant. Probability ranking according to SUCRA showed that there was a great possibility for foam and chitosan in the treatment of DF. Conclusion Based on the results of network meta-analysis and rank, foam dressing and chitosan dressing are superior to other dressings in the treatment of DF. More attentions should be made regarding comparisons directly of different dressing and reporting of cost-effective analysis.

Citation： HOUYu-ying, ZHANGZhi-gang, ZHANGJun, ZHANGJu-xia, WANGBo, YANGAi-ling, TIANJin-hui. Effects of Nine Different Dressings in the Treatment of Diabetic Foot: A Network Meta-analysis. Chinese Journal of Evidence-Based Medicine, 2016, 16(11): 1291-1297. doi: 10.7507/1672-2531.20160196 Copy

1.	尤黎明, 吳瑛.內科護理學.第5版.北京:人民衛生出版社, 2012:584.
2.	田金徽, 陳耀龍, 楊克虎, 等. SR/MA研究進展與挑戰.蘭州大學學報:醫學版, 2016, 42(42):42-47.
3.	曾憲濤, 曹世義, 孫鳳, 等. Meta分析系列之六:間接比較與網狀Meta分析.中國循證心血管醫學雜志, 2012, 4(5):399-402.
4.	Lalau JD, Bresson R, Charpentier P, et al. Efficacy and tolerance of calcium alginate versus vaseline gauze dressings in the treatment of diabetic foot lesions. Diabetes Metab, 2002, 28(3):223-239.
5.	Jude EB, Apelqvist J, Spraul M, et al. Prospective randomized controlled study of Hydrofiber dressing containing ionic silver or calcium alginate dressings in non-ischaemic diabetic foot ulcers. Diabet Med, 2007, 24(3):280-288.
6.	Driver VR, Hanft J, Fylling CP, et al. A prospective, randomized, controlled trial of autologous platelet-rich plasma gel for the treatment of diabetic foot ulcers. Ostomy Wound Manage, 2006, 52(6):68-70.
7.	邱吉苗, 謝翠華, 李春榮.含銀離子敷料治療糖尿病足潰瘍50例.廣東醫學, 2007, 28(3):472-472.
8.	陸新虹, 溫玉潔, 胡欣.含銀離子敷料慷舒靈治療糖尿病足療效觀察.臨床醫藥實踐, 2009, 18(6):1810-1811.
9.	李旭亞, 丁惠萍.糖尿病足感染傷口治療中使用銀離子敷料的臨床觀察.護理實踐與研究, 2009, 6(20):34-35.
10.	邱錦媚, 廖啟清, 蘇麗.慷舒靈治療糖尿病足潰瘍創面效果觀察.中外醫療, 2010, 29(9):48-49.
11.	胡惠蘭, 陳麗靜, 莫桂英, 等.司膚泰克軟聚硅酮粘膠類敷料在糖尿病足局部潰瘍的應用.臨床護理雜志, 2010, 9(3):20-22.
12.	孔莉, 孫中安, 戴冬梅.釉原蛋白殼聚糖敷料用于糖尿病足護理的臨床效果.全國內科護理學術交流暨專題講座會議, 全國心臟內、外科護理學術交流暨專題講座會議, 全國第8屆糖尿病護理學術交流暨專題講座會議, 全國第8屆血液凈化護理學術交流暨專題講座會議論文匯編. 2010.
13.	蔡麗萍, 牛玲, 王芳, 等.兩種敷料運用于糖尿病足治療的療效觀察.實用糖尿病雜志, 2011, 7(5):13-14.
14.	陳秋玲, 胡惠蘭.司膚泰克軟聚硅酮黏膠類敷料治療糖尿病足患者的效果評價.中國實用護理雜志, 2011, 27(17):12-13.
15.	劉仁海, 高霞.含銀離子敷料治療2-3級糖尿病足潰瘍42例.中國藥業, 2012, 21(9):50-51.
16.	崔劍鋒.慷舒靈凝膠治療糖尿病足潰瘍的臨床療效觀察.中國醫療前沿, 2012, 7(15):21-21.
17.	周紅菊, 鄧瑞文, 饒忠, 等.藻酸鹽敷料治療糖尿病足潰瘍的臨床觀察和護理.護士進修雜志, 2012, 27(13):1219-1221.
18.	Kamaratos AV, Tzirogiannis KN, Iraklianou SA, et al. Manuka honey-impregnated dressings in the treatment of neuropathic diabetic foot ulcers. Int Wound J, 2014, 11(3):259-263.
19.	宗玉如.愛康膚銀治療糖尿病足的療效觀察.實用臨床醫藥雜志, 2013, 17(20):110-111.
20.	范亞莉, 王海過, 李京紅.多愛膚銀離子敷料治療糖尿病足的臨床觀察.山西醫藥雜志:上半月, 2013, 42(8):914-915.
21.	李華.納米銀醫用抗菌敷料在糖尿病足護理中的應用.中華醫院感染學雜志, 2013, 23(5):1162.
22.	朱燕, 高艷萍, 郭源春.兩種換藥方式在老年糖尿病足護理中的效果比較分析.醫學信息, 2013, 26(11):99.
23.	陸艷, 黃偉英.凝膠敷料用于糖尿病足潰瘍的療效觀察.醫學信息, 2014, 27(10):86.
24.	田杰, 朱旭暉.司膚泰克軟聚硅酮黏膠類敷料治療糖尿病足患者的效果評價.大家健康(學術版), 2014, 8(15):375.
25.	張春濤, 馮肖玲, 吳思穎.納米銀敷料在糖尿病足患者護理中的效果觀察.當代醫學, 2015, 21(4):110-111.
26.	陳如賢, 孔燕坤, 郭金鳳.藻酸鹽敷料治療糖尿病足潰瘍的臨床觀察和護理.北方藥學, 2015, 12(11):186-186.
27.	李萍, 陳儉波, 沃紅霞, 等.三黃濕敷水凝膠治療糖尿病足潰瘍創面臨床療效觀察.內蒙古中醫藥, 2015, 34(12):18-19.
28.	Imran M, Hussain M B, Baig M. A randomized, controlled clinical trial of honey-impregnated dressing for treating diabetic foot ulcer. J Coll Physicians Surg Pak, 2015, 25(10):721-725.
29.	孫瑜.不同換藥方式對糖尿病足患者護理干預效果研究.健康研究, 2015, 35(3):326-327.
30.	劉洋, 張迪.不同換藥方式對糖尿病足患者臨床護理效果的影響.國際醫藥衛生導報, 2015, 21(20):3093-3095.
31.	關麗坤.兩種換藥方式在老年糖尿病足護理中的效果比較.世界最新醫學信息文摘, 2015, 15(66):184.
32.	何芳, 徐莎, 陳偉.含銀抗菌凝膠慷舒靈局部換藥治療糖尿病足的療效觀察.當代護士:專科版(下旬刊), 2016, (2):94-95.
33.	張靜, 丁彩云, 何紅.銀離子敷料聯合水凝膠治療糖尿病足的Meta分析.中國實用護理雜志, 2013, 29(29):17-21.
34.	Dumville JC, O'Meara S, Deshpande S, et al. Alginate dressings for healing diabetic foot ulcers. Cochrane Database Syst Rev, 2013, 6:CD009110.

1. 尤黎明, 吳瑛.內科護理學.第5版.北京:人民衛生出版社, 2012:584.
2. 田金徽, 陳耀龍, 楊克虎, 等. SR/MA研究進展與挑戰.蘭州大學學報:醫學版, 2016, 42(42):42-47.
3. 曾憲濤, 曹世義, 孫鳳, 等. Meta分析系列之六:間接比較與網狀Meta分析.中國循證心血管醫學雜志, 2012, 4(5):399-402.
4. Lalau JD, Bresson R, Charpentier P, et al. Efficacy and tolerance of calcium alginate versus vaseline gauze dressings in the treatment of diabetic foot lesions. Diabetes Metab, 2002, 28(3):223-239.
5. Jude EB, Apelqvist J, Spraul M, et al. Prospective randomized controlled study of Hydrofiber dressing containing ionic silver or calcium alginate dressings in non-ischaemic diabetic foot ulcers. Diabet Med, 2007, 24(3):280-288.
6. Driver VR, Hanft J, Fylling CP, et al. A prospective, randomized, controlled trial of autologous platelet-rich plasma gel for the treatment of diabetic foot ulcers. Ostomy Wound Manage, 2006, 52(6):68-70.
7. 邱吉苗, 謝翠華, 李春榮.含銀離子敷料治療糖尿病足潰瘍50例.廣東醫學, 2007, 28(3):472-472.
8. 陸新虹, 溫玉潔, 胡欣.含銀離子敷料慷舒靈治療糖尿病足療效觀察.臨床醫藥實踐, 2009, 18(6):1810-1811.
9. 李旭亞, 丁惠萍.糖尿病足感染傷口治療中使用銀離子敷料的臨床觀察.護理實踐與研究, 2009, 6(20):34-35.
10. 邱錦媚, 廖啟清, 蘇麗.慷舒靈治療糖尿病足潰瘍創面效果觀察.中外醫療, 2010, 29(9):48-49.
11. 胡惠蘭, 陳麗靜, 莫桂英, 等.司膚泰克軟聚硅酮粘膠類敷料在糖尿病足局部潰瘍的應用.臨床護理雜志, 2010, 9(3):20-22.
12. 孔莉, 孫中安, 戴冬梅.釉原蛋白殼聚糖敷料用于糖尿病足護理的臨床效果.全國內科護理學術交流暨專題講座會議, 全國心臟內、外科護理學術交流暨專題講座會議, 全國第8屆糖尿病護理學術交流暨專題講座會議, 全國第8屆血液凈化護理學術交流暨專題講座會議論文匯編. 2010.
13. 蔡麗萍, 牛玲, 王芳, 等.兩種敷料運用于糖尿病足治療的療效觀察.實用糖尿病雜志, 2011, 7(5):13-14.
14. 陳秋玲, 胡惠蘭.司膚泰克軟聚硅酮黏膠類敷料治療糖尿病足患者的效果評價.中國實用護理雜志, 2011, 27(17):12-13.
15. 劉仁海, 高霞.含銀離子敷料治療2-3級糖尿病足潰瘍42例.中國藥業, 2012, 21(9):50-51.
16. 崔劍鋒.慷舒靈凝膠治療糖尿病足潰瘍的臨床療效觀察.中國醫療前沿, 2012, 7(15):21-21.
17. 周紅菊, 鄧瑞文, 饒忠, 等.藻酸鹽敷料治療糖尿病足潰瘍的臨床觀察和護理.護士進修雜志, 2012, 27(13):1219-1221.
18. Kamaratos AV, Tzirogiannis KN, Iraklianou SA, et al. Manuka honey-impregnated dressings in the treatment of neuropathic diabetic foot ulcers. Int Wound J, 2014, 11(3):259-263.
19. 宗玉如.愛康膚銀治療糖尿病足的療效觀察.實用臨床醫藥雜志, 2013, 17(20):110-111.
20. 范亞莉, 王海過, 李京紅.多愛膚銀離子敷料治療糖尿病足的臨床觀察.山西醫藥雜志:上半月, 2013, 42(8):914-915.
21. 李華.納米銀醫用抗菌敷料在糖尿病足護理中的應用.中華醫院感染學雜志, 2013, 23(5):1162.
22. 朱燕, 高艷萍, 郭源春.兩種換藥方式在老年糖尿病足護理中的效果比較分析.醫學信息, 2013, 26(11):99.
23. 陸艷, 黃偉英.凝膠敷料用于糖尿病足潰瘍的療效觀察.醫學信息, 2014, 27(10):86.
24. 田杰, 朱旭暉.司膚泰克軟聚硅酮黏膠類敷料治療糖尿病足患者的效果評價.大家健康(學術版), 2014, 8(15):375.
25. 張春濤, 馮肖玲, 吳思穎.納米銀敷料在糖尿病足患者護理中的效果觀察.當代醫學, 2015, 21(4):110-111.
26. 陳如賢, 孔燕坤, 郭金鳳.藻酸鹽敷料治療糖尿病足潰瘍的臨床觀察和護理.北方藥學, 2015, 12(11):186-186.
27. 李萍, 陳儉波, 沃紅霞, 等.三黃濕敷水凝膠治療糖尿病足潰瘍創面臨床療效觀察.內蒙古中醫藥, 2015, 34(12):18-19.
28. Imran M, Hussain M B, Baig M. A randomized, controlled clinical trial of honey-impregnated dressing for treating diabetic foot ulcer. J Coll Physicians Surg Pak, 2015, 25(10):721-725.
29. 孫瑜.不同換藥方式對糖尿病足患者護理干預效果研究.健康研究, 2015, 35(3):326-327.
30. 劉洋, 張迪.不同換藥方式對糖尿病足患者臨床護理效果的影響.國際醫藥衛生導報, 2015, 21(20):3093-3095.
31. 關麗坤.兩種換藥方式在老年糖尿病足護理中的效果比較.世界最新醫學信息文摘, 2015, 15(66):184.
32. 何芳, 徐莎, 陳偉.含銀抗菌凝膠慷舒靈局部換藥治療糖尿病足的療效觀察.當代護士:專科版(下旬刊), 2016, (2):94-95.
33. 張靜, 丁彩云, 何紅.銀離子敷料聯合水凝膠治療糖尿病足的Meta分析.中國實用護理雜志, 2013, 29(29):17-21.
34. Dumville JC, O'Meara S, Deshpande S, et al. Alginate dressings for healing diabetic foot ulcers. Cochrane Database Syst Rev, 2013, 6:CD009110.

Chinese Journal of Evidence-Based Medicine

Effects of Nine Different Dressings in the Treatment of Diabetic Foot: A Network Meta-analysis

Abstract Full text Figures/Tables Video References Cited by

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