Dressings for healing venous leg ulcers

Simon S J Palfreyman, E Andrea Nelson, Rona Lochiel, Jonathan A Michaels

Research output: Contribution to journalArticle

Abstract

Background
Venous leg ulcers, sometimes called varicose or stasis ulcers, are a consequence of damage to the valves in the veins of the legs, leading to raised venous pressure. Venous ulcers are characterised by a cyclical pattern of healing and recurrence. The main treatment is the application of compression, either in the form of compression bandages or hosiery. Dressings are usually applied beneath the compression to aid healing, comfort and to control exudate. Wounds heal quicker in a moist environment and dressings are used to absorb excess fluid or retain fluid in an otherwise dry wound in order to achieve a 'moist wound environment'. There are a large number of dressing products and types available. It is unclear whether particular dressings aid healing of leg ulcers.

Objectives
To assess the effectiveness of wound dressings for the treatment of venous leg ulcers.

Search methods
We searched the Cochrane Wounds Group Specialised Register (April 2006) and CENTRAL (issue 1, 2006) and several other electronic databases (up to April 2005). Manufacturers of dressing products were contacted for unpublished studies.

Selection criteria
Randomised controlled trials that evaluated dressings for the treatment of venous leg ulcers. There was no restriction in terms of source, date of publication or language. Ulcer healing was the primary endpoint.

Data collection and analysis
Data from eligible studies were extracted and summarised using a data extraction sheet by two authors independently.

Main results
42 randomised controlled studies were identified that met the inclusion criteria. The main dressing types that were evaluated were hydrocolloids (n = 23), foams (n = 6), alginates (n = 4), hydrogel dressings (n = 6) and a group of miscellaneous dressings (n = 3). In none of the comparisons was there evidence that any one dressing type was better than others in terms of number of ulcers healed. Current evidence does not suggest that hydrocolloids are more effective than simple low adherent dressings used beneath compression (9 trials; relative risk for healing with hydrocolloid 1.09 (95% CI 0.89 to 1.34)). For other comparisons there was insufficient evidence.
Original languageEnglish
Article numberCD001103
Pages (from-to)1-78
Number of pages79
JournalCochrane Database of Systematic Reviews
Volume2006
Issue number3
DOIs
Publication statusPublished - Jul 2006

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Keywords

  • venous leg ulcers
  • compression therapy
  • wound repair
  • dressing products
  • randomised controlled trials

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