Dressing Diabetic Foot Ulcers

Diabetic foot ulcers dressed in cheaper dressing heal just as well as in more expensive dressings

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Foot ulcers are a common problem among people with diabetes. If a patient develops one of these open wounds, dressings help the wound heal and prevent infection. So, which type of dressing works best?

Foot ulcers in people with diabetes may heal just as well using cheaper dressings as using more expensive dressings.

"Get your foot ulcers treated immediately."

Dressings are a key part of treating ulcers, with doctors having many options to choose from.

Jo Dumville, PhD, of the University of York in the United Kingdom, and colleagues set out to see which type of dressing best promoted healing of diabetic foot ulcers.

They looked at 15 past studies comparing the effectiveness of dressings. While some of these studies showed that certain dressings had more healing effectiveness than others, the researchers said the evidence was weak.

In general, there was little evidence that one dressing was better than the other.

"[This study] highlights that more expensive dressings may offer no advantages in terms of healing than cheaper, basic dressing," the authors wrote.

"The work also highlights the risk of bias in some studies and how this can impact on interpretation of [findings]," they wrote. That is, the studies that found differences in healing power between dressings had low quality evidence due to small study sizes and potential conflicts of interest.

"There was evidence that hydrogel dressings were associated with significantly higher odds of ulcer healing than basic wound dressings," the authors write. "However, this finding was driven by low quality evidence, encompassing two small studies, one with unclear risk of bias and one at high risk of bias." 

Foam dressings seemed to increase the chance of ulcer healing, compared to basic wound contact dressings. However, this evidence was also considered weak.

Basic wound contact dressings are the cheapest and easiest of dressings.

The results of this study suggest that basic wound contact dressings are just as effective than other more complex dressings.

"Thus…there was no evidence of a difference in healing between more expensive dressings compared with cheaper alternatives," the authors wrote.

They added that there was no difference between dressings that fought off microorganisms (i.e., bacteria, fungi, or protozoans) and those that did not.

The nine dressings types assessed in the study included: hydrocolloid dressings (sold as Duoderm, Granuflex, and 3M Tegaderm Hydrocolloid), foam, hydrogel, silver fibrous hydrocolloid dressings, protease-modulating dressings, impregnated-iodine, fibrous hydrocolloid dressings, alginate dressings and basic wound contact dressings.

The research was funded by the National Institute for Health Research.

The study was published April 29 in the journal Diabetologia.

Reviewed by: 
Review Date: 
July 19, 2012
Last Updated:
February 26, 2013