1/30/2024 0 Comments Oil emulsion dressing vs xeroform![]() Venous leg ulcers are open wounds caused by poor blood flow through the veins of the lower leg. The main treatment for venous leg ulcers is compression bandages or stockings and the choice of additional dressings or topical treatments should take into account the review findings and their uncertainty, alongside factors such as patient preference and cost. We cannot be certain which dressings and topical agents are most effective for healing venous leg ulcers: over all studies there were not enough participants per treatment and there was high risk of bias this means that many of the studies were conducted or reported in a way that means we cannot be sure if the results are accurate. We evaluated these studies using a method known as network meta‐analysis (NMA), which allowed us to compare treatments across different studies and to rank them in terms of complete ulcer healing. This type of trial provides the most reliable evidence. Randomised controlled trials are medical studies where patients are chosen at random to receive different treatments. Researchers from Cochrane found 78 relevant studies (randomised controlled trials) to answer this question. These are long‐term wounds in the lower leg caused by problems with blood flow back up the leg through the veins. The aim of this review is to find out which dressings and topical agents (gels, ointments and creams) are most effective for treating a type of wound known as venous leg ulcers. For all other combinations of these five interventions it was unclear whether the intervention increased the probability of healing in each case this was low‐ or very low‐certainty evidence as a consequence of one or more of imprecision, risk of bias and inconsistency.ĭressings and topical agents (gels, ointments and creams) for treating venous leg ulcers When exploring the data for silver and sucralfate compared with widely‐used dressing classes, there was some evidence that silver dressings may increase the probability of venous leg ulcer healing, compared with nonadherent dressings: RR 2.43, 95% CI 1.58 to 3.74 (moderate‐certainty evidence in the context of a low‐certainty network). However, the data for sucralfate was from one small study, which means that this finding should be interpreted with caution. The two most highly‐ranked treatments both had more than 50% probability of being the best (sucralfate and silver dressings). The uncertainty was perpetuated when the results were considered by ranking the treatments in terms of the probability that they were the most effective for ulcer healing, with many treatments having similar, low, probabilities of being the best treatment. ![]() Evidence for individual contrasts was mainly judged to be low or very low certainty. Sensitivity analyses also demonstrated instability in key aspects of the network and results are reported for the extended sensitivity analysis. This judgement was based on the sparsity of the network leading to imprecision and the general high risk of bias in the included studies. ![]() The evidence for the network as a whole was of low certainty. Of these, 59 studies (5156 participants, 25 different interventions) were included in the NMA resulting in 40 direct contrasts which informed 300 mixed‐treatment contrasts. We included 78 RCTs (7014 participants) in this review. ![]()
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