Dressings and Topical Agents for Chronic Wounds - NIHR Health ...

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ResultsHolzinger et al., 1994 70Comparison: Placebo vs. Autologous activatedmononuclear cellsMean baseline area (cm 2 ): 5.26 (2.9 SD) 5.14 (2.7 SD)Sample size (N) (venous): 30 (10) 33 (12)No. of wounds healed (n/N):Venous 7/10 (70%) 11/12 (92%) 4.7 (0.4, 54.9)Arterial 10/20 (50%) 18/21 (86%) 6.0 (1.3, 27.0)Placebo:Wound type:Follow-up time:Tissue culture mediumArterial and venous leg ulcersMaximum of 75 daysDuhra et al., 1992 119Comparison: Placebo vs. Keratinocyte allograftsMedian baseline area (cm 2 ): 10.7 (1.7 SEM) 9.1 (1.6 SEM)Sample size (N): 15 (11 patients) 15 (11 patients)No. of wounds healed (n/N): 1/15 (7%) 0/15 (0%) 0.3 (0.01, 8.3)Reduction in mean absolutewound area (cm 2 ): 3.3 2.7 –0.6Placebo:Wound type:Follow-up time:Paraffin gauze soaked in culture mediumVenous leg ulcers6 weeksRundle et al., 1981 117Comparison: Paste bandage vs. Porcine dermisMedian baseline area (cm 2 ): 3.0 2.0(range, 0.5–45.0) (range, 0.2–47.8)Sample size (N): 19 23Median time to healing (weeks): 9 (range, 3–63) 6 (range, 1–16) 21 daysWound type:Follow-up time:Venous leg ulcersNot statedSabolinski et al., 1996 118Comparison: Non-adherent vs. Living skin equivalentdressingMean baseline area (cm 2 ): Not stated Not statedSample size (N) * : Not stated Not statedMedian time to healing (days): 181 57 124 daysWound type:Follow-up time:Venous leg ulcersNot stated* 233 patients0.01 0.1 1 10 100 OR(95% CI)–100 –50 0 50ES100 (95% CI)ES–4 –2 0 2 4 (95% CI)Favours placebo Favours biological dressing32FIGURE 18 Biologically active agents compared with placebo or traditional dressings for venous and arterial leg ulcers
Health Technology Assessment 1999; Vol. 3: No. 17 (Pt 2)Calabro et al., 1995 85Comparison: Traditional vs. Topical (fibrin glue)Mean baseline area (cm 2 ): Not stated Not statedSample size (N): 54 26No. of wounds healed (n/N): 48/54 (89%) 20/26 (77%) 0.41 (0.12, 1.45)Traditional therapy: Paraffin or betadine gauzeWound type: Venous leg ulcersFollow-up time: UnclearTsakayannis et al., 1994 122Comparison: Control vs. SucralfateMean baseline area (cm 2 ): Not stated Not statedSample size (patients/wounds): 5/5 4/5No. of wounds healed (n/N): 0/5 (0%) 2/5 (40%) 11.0 (0.37, 324)Traditional therapy: Vehicle aloneWound type: Venous leg ulcersFollow-up time: 8 weeksSalim, 1991 123Comparison: Placebo vs. DMSOBaseline area (cm 2 ): 4.1 (0.2 SEM) 4.6 (0.7 SEM)Sample size (N): 52 50No. of wounds healed (n/N): 31/52 (60%) 42/50 (84%) 3.28 (1.39, 7.71)Reduction in wound area (cm 2 ): 2.8 4.6 1.6Comparison: Placebo vs. AllopurinolBaseline area (cm 2 ): 4.1 (0.2 SEM) 4.4 (0.5 SEM)Sample size (N): 52 51No. of wounds healed (n/N): 31/52 (60%) 42/51 (82%) 2.98 (1.28, 6.94)Reduction in wound area (cm 2 ): 2.8 4.4 1.3Placebo:Inert powderWound type: Venous leg ulcersFollow-up time: 12 weeksSalim, 1992 124Comparison: Placebo vs. DL-cysteineBaseline area (cm 2 ): 4.6 (0.2 SEM) 5.3 (0.3 SEM)Sample size (N): 55 57No. of wounds healed (n/N): 32/55 (58%) 43/57 (75%) 2.17 (0.99, 4.75)Reduction in wound area (cm 2 ): 3.5 4.9 1.4Comparison: Placebo vs. Methionine-methylsulphonium chlorideBaseline area (cm 2 ): 4.6 (0.2 SEM) 4.4 (0.5 SEM)Sample size (N): 55 56No. of wounds healed (n/N): 32/55 (58%) 42/51 (82%) 1.33 (0.20, 9.02)Reduction in wound area (cm 2 ): 3.5 5.0 1.5Placebo:Inert powderWound type: Venous leg ulcersFollow-up time: 12 weeks0.01 0.1 1 10 100 OR(95% CI)ES–4 –2 0 2 4 (95% CI)Favours control/placeboFavours topical agentFIGURE 19 Topical dressings compared with placebo/traditional dressings for venous leg ulcers33
Page 1 and 2: Health Technology Assessment 1999;
Page 3 and 4: Systematic reviews of wound careman
Page 7: Health Technology Assessment 1999;
Page 10 and 11: Executive summarythan either an alg
Page 12 and 13: Introduction2sores) or due to under
Page 14 and 15: Introduction4healing rates are low
Page 22 and 23: ResultsMacfie & McMahon, 1980 34Com
Page 24 and 25: ResultsLe Vasseur & Helme, 1991 40C
Page 26 and 27: ResultsMustoe et al., 1994 43Compar
Page 28 and 29: ResultsSayag et al., 1996 49Compari
Page 30 and 31: ResultsOleske et al., 1986 57Compar
Page 32 and 33: ResultsBrod et al., 1990 66Comparis
Page 34 and 35: ResultsMoffatt et al., 1992 88Compa
Page 36 and 37: ResultsArnold et al., 1994 99Compar
Page 38 and 39: Results28healed under a lyophilised
Page 40 and 41: ResultsZuccarelli, 1993 113Comparis
Page 44 and 45: ResultsWerner-Schlenzka & Kuhlmann,
Page 46 and 47: ResultsTosti & Veronesi, 1983 132Co
Page 48 and 49: ResultsSix trials evaluated cost-ef
Page 50 and 51: Discussion40Several trials evaluate
Page 52 and 53: Discussionmay also exist for other
Page 54 and 55: Conclusionssupport, promote collabo
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HTA Commissioning BoardCurrent memb
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