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

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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, 吴瑛.内科护理学.第5版.北京:人民卫生出版社, 2012:584.
2.	田金徽, 陈耀龙, 杨克虎, 等. SR/MA研究进展与挑战.兰州大学学报:医学版, 2016, 42(42):42-47.
3.	曾宪涛, 曹世义, 孙凤, 等. Meta分析系列之六:间接比较与网状Meta分析.中国循证心血管医学杂志, 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, 谢翠华, 李春荣.含银离子敷料治疗糖尿病足溃疡50例.广东医学, 2007, 28(3):472-472.
8.	陆新虹, 温玉洁, 胡欣.含银离子敷料慷舒灵治疗糖尿病足疗效观察.临床医药实践, 2009, 18(6):1810-1811.
9.	李旭亚, 丁惠萍.糖尿病足感染伤口治疗中使用银离子敷料的临床观察.护理实践与研究, 2009, 6(20):34-35.
10.	邱锦媚, 廖启清, 苏丽.慷舒灵治疗糖尿病足溃疡创面效果观察.中外医疗, 2010, 29(9):48-49.
11.	胡惠兰, 陈丽静, 莫桂英, 等.司肤泰克软聚硅酮粘胶类敷料在糖尿病足局部溃疡的应用.临床护理杂志, 2010, 9(3):20-22.
12.	孔莉, 孙中安, 戴冬梅.釉原蛋白壳聚糖敷料用于糖尿病足护理的临床效果.全国内科护理学术交流暨专题讲座会议, 全国心脏内、外科护理学术交流暨专题讲座会议, 全国第8届糖尿病护理学术交流暨专题讲座会议, 全国第8届血液净化护理学术交流暨专题讲座会议论文汇编. 2010.
13.	蔡丽萍, 牛玲, 王芳, 等.两种敷料运用于糖尿病足治疗的疗效观察.实用糖尿病杂志, 2011, 7(5):13-14.
14.	陈秋玲, 胡惠兰.司肤泰克软聚硅酮黏胶类敷料治疗糖尿病足患者的效果评价.中国实用护理杂志, 2011, 27(17):12-13.
15.	刘仁海, 高霞.含银离子敷料治疗2-3级糖尿病足溃疡42例.中国药业, 2012, 21(9):50-51.
16.	崔剑锋.慷舒灵凝胶治疗糖尿病足溃疡的临床疗效观察.中国医疗前沿, 2012, 7(15):21-21.
17.	周红菊, 邓瑞文, 饶忠, 等.藻酸盐敷料治疗糖尿病足溃疡的临床观察和护理.护士进修杂志, 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.爱康肤银治疗糖尿病足的疗效观察.实用临床医药杂志, 2013, 17(20):110-111.
20.	范亚莉, 王海过, 李京红.多爱肤银离子敷料治疗糖尿病足的临床观察.山西医药杂志:上半月, 2013, 42(8):914-915.
21.	李华.纳米银医用抗菌敷料在糖尿病足护理中的应用.中华医院感染学杂志, 2013, 23(5):1162.
22.	朱燕, 高艳萍, 郭源春.两种换药方式在老年糖尿病足护理中的效果比较分析.医学信息, 2013, 26(11):99.
23.	陆艳, 黄伟英.凝胶敷料用于糖尿病足溃疡的疗效观察.医学信息, 2014, 27(10):86.
24.	田杰, 朱旭晖.司肤泰克软聚硅酮黏胶类敷料治疗糖尿病足患者的效果评价.大家健康(学术版), 2014, 8(15):375.
25.	张春涛, 冯肖玲, 吴思颖.纳米银敷料在糖尿病足患者护理中的效果观察.当代医学, 2015, 21(4):110-111.
26.	陈如贤, 孔燕坤, 郭金凤.藻酸盐敷料治疗糖尿病足溃疡的临床观察和护理.北方药学, 2015, 12(11):186-186.
27.	李萍, 陈俭波, 沃红霞, 等.三黄湿敷水凝胶治疗糖尿病足溃疡创面临床疗效观察.内蒙古中医药, 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.	孙瑜.不同换药方式对糖尿病足患者护理干预效果研究.健康研究, 2015, 35(3):326-327.
30.	刘洋, 张迪.不同换药方式对糖尿病足患者临床护理效果的影响.国际医药卫生导报, 2015, 21(20):3093-3095.
31.	关丽坤.两种换药方式在老年糖尿病足护理中的效果比较.世界最新医学信息文摘, 2015, 15(66):184.
32.	何芳, 徐莎, 陈伟.含银抗菌凝胶慷舒灵局部换药治疗糖尿病足的疗效观察.当代护士:专科版(下旬刊), 2016, (2):94-95.
33.	张静, 丁彩云, 何红.银离子敷料联合水凝胶治疗糖尿病足的Meta分析.中国实用护理杂志, 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, 吴瑛.内科护理学.第5版.北京:人民卫生出版社, 2012:584.
2. 田金徽, 陈耀龙, 杨克虎, 等. SR/MA研究进展与挑战.兰州大学学报:医学版, 2016, 42(42):42-47.
3. 曾宪涛, 曹世义, 孙凤, 等. Meta分析系列之六:间接比较与网状Meta分析.中国循证心血管医学杂志, 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, 谢翠华, 李春荣.含银离子敷料治疗糖尿病足溃疡50例.广东医学, 2007, 28(3):472-472.
8. 陆新虹, 温玉洁, 胡欣.含银离子敷料慷舒灵治疗糖尿病足疗效观察.临床医药实践, 2009, 18(6):1810-1811.
9. 李旭亚, 丁惠萍.糖尿病足感染伤口治疗中使用银离子敷料的临床观察.护理实践与研究, 2009, 6(20):34-35.
10. 邱锦媚, 廖启清, 苏丽.慷舒灵治疗糖尿病足溃疡创面效果观察.中外医疗, 2010, 29(9):48-49.
11. 胡惠兰, 陈丽静, 莫桂英, 等.司肤泰克软聚硅酮粘胶类敷料在糖尿病足局部溃疡的应用.临床护理杂志, 2010, 9(3):20-22.
12. 孔莉, 孙中安, 戴冬梅.釉原蛋白壳聚糖敷料用于糖尿病足护理的临床效果.全国内科护理学术交流暨专题讲座会议, 全国心脏内、外科护理学术交流暨专题讲座会议, 全国第8届糖尿病护理学术交流暨专题讲座会议, 全国第8届血液净化护理学术交流暨专题讲座会议论文汇编. 2010.
13. 蔡丽萍, 牛玲, 王芳, 等.两种敷料运用于糖尿病足治疗的疗效观察.实用糖尿病杂志, 2011, 7(5):13-14.
14. 陈秋玲, 胡惠兰.司肤泰克软聚硅酮黏胶类敷料治疗糖尿病足患者的效果评价.中国实用护理杂志, 2011, 27(17):12-13.
15. 刘仁海, 高霞.含银离子敷料治疗2-3级糖尿病足溃疡42例.中国药业, 2012, 21(9):50-51.
16. 崔剑锋.慷舒灵凝胶治疗糖尿病足溃疡的临床疗效观察.中国医疗前沿, 2012, 7(15):21-21.
17. 周红菊, 邓瑞文, 饶忠, 等.藻酸盐敷料治疗糖尿病足溃疡的临床观察和护理.护士进修杂志, 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.爱康肤银治疗糖尿病足的疗效观察.实用临床医药杂志, 2013, 17(20):110-111.
20. 范亚莉, 王海过, 李京红.多爱肤银离子敷料治疗糖尿病足的临床观察.山西医药杂志:上半月, 2013, 42(8):914-915.
21. 李华.纳米银医用抗菌敷料在糖尿病足护理中的应用.中华医院感染学杂志, 2013, 23(5):1162.
22. 朱燕, 高艳萍, 郭源春.两种换药方式在老年糖尿病足护理中的效果比较分析.医学信息, 2013, 26(11):99.
23. 陆艳, 黄伟英.凝胶敷料用于糖尿病足溃疡的疗效观察.医学信息, 2014, 27(10):86.
24. 田杰, 朱旭晖.司肤泰克软聚硅酮黏胶类敷料治疗糖尿病足患者的效果评价.大家健康(学术版), 2014, 8(15):375.
25. 张春涛, 冯肖玲, 吴思颖.纳米银敷料在糖尿病足患者护理中的效果观察.当代医学, 2015, 21(4):110-111.
26. 陈如贤, 孔燕坤, 郭金凤.藻酸盐敷料治疗糖尿病足溃疡的临床观察和护理.北方药学, 2015, 12(11):186-186.
27. 李萍, 陈俭波, 沃红霞, 等.三黄湿敷水凝胶治疗糖尿病足溃疡创面临床疗效观察.内蒙古中医药, 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. 孙瑜.不同换药方式对糖尿病足患者护理干预效果研究.健康研究, 2015, 35(3):326-327.
30. 刘洋, 张迪.不同换药方式对糖尿病足患者临床护理效果的影响.国际医药卫生导报, 2015, 21(20):3093-3095.
31. 关丽坤.两种换药方式在老年糖尿病足护理中的效果比较.世界最新医学信息文摘, 2015, 15(66):184.
32. 何芳, 徐莎, 陈伟.含银抗菌凝胶慷舒灵局部换药治疗糖尿病足的疗效观察.当代护士:专科版(下旬刊), 2016, (2):94-95.
33. 张静, 丁彩云, 何红.银离子敷料联合水凝胶治疗糖尿病足的Meta分析.中国实用护理杂志, 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

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