Primary studies included in this systematic review

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Primary study

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Cost-effectiveness analysis in comparing alginate silver dressing with silver zinc sulfadiazine cream in the treatment of pressure ulcers

Revista Archives of plastic surgery
Year 2013
Links Pubmed Health Technology Assessment (HTA) DOI PubMed Central crd.york.ac.uk
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Background The treatment of pressure ulcers is complicated, given the various wound dressing products available. The cost of different treatments varies and the cost-effectiveness of each product has not been thoroughly evaluated. We compare two wound dressing protocolsalginate silver dressing (AlSD) and silver zinc sulfadiazine cream (AgZnSD) with regard to wound healing and cost-effectiveness Methods Patients with grade III or IV sacral or trochanteric pressure ulcers were eligible for this prospective, randomized controlled trial. The patients were randomized to receive one of the two dressings for an eight-week period. The criteria of efficacy were based on the Pressure Ulcer Scale for Healing (PUSH) scoring tool. The cost of treatment was also assessed. Results Twenty patients (12 women and 8 men) were randomly assigned to receive either AlSD (n=10) or AgZnSD cream (n=10). The demographic data and wound characteristics were comparable in the two groups. The two groups showed no significant difference in the reduction of PUSH score, wound size, or volume of exudate. The tissue type score was significantly lower in the AlSD group (3.15±0.68-1.85±0.68 vs. 2.73±0.79-2.2±0.41; P=0.015). The cost of treatment was significantly lower in the AlSD group (377.17 vs. 467.74 USD, respectively; P<0.0001). Conclusions Alginate silver dressing could be effectively used in the treatment of grade III and IV pressure ulcers. It can improve wound tissue characteristics and is cost-effective. © 2013 The Korean Society of Plastic and Reconstructive Surgeons.

Primary study

Unclassified

Efeito benéfico da pomada resina no tratamento de úlceras de pressão graves: um estudo prospectivo, multicêntrico, randomizado e controlado.

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Revista The British journal of dermatology
Year 2008
Links Pubmed DOI
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TEMA: salve Resina do abeto da Noruega (Picea abies) tem sido utilizada na medicina popular para curar feridas e infecções. OBJETIVOS: estudar a sua eficácia clínica no tratamento de úlceras de pressão da pele. MÉTODOS: A, randomizado multicêntrico prospectivo, controlado envolvendo 37 pacientes com úlceras de pressão grau II-IV em 11 hospitais de cuidados primários foi realizada entre 2005 e 2007. As úlceras foram alocados aleatoriamente para receber ou salve resina ou carboximetilcelulose tratamento polímero hydrocolloid de sódio. O critério de inclusão foi de grau II-IV de úlceras de pressão. Os critérios de exclusão foram uma expectativa de vida de menos de 6 meses ou uma doença maligna vida. O desfecho primário foi a cicatrização completa da úlcera dentro de 6 meses. Desfechos secundários foram cura parcial da úlcera e erradicação bem-sucedida de cepas bacterianas cultivadas a partir das úlceras no início do estudo. RESULTADOS: Treze pacientes do grupo de resina e nove pacientes do grupo controle completaram o ensaio seis meses. Todas as úlceras curadas em 12 dos 13 pacientes (92%) no grupo da resina e em quatro dos nove pacientes (44%) no grupo de controlo (P = 0,003, 73% de potência). A cura completa das úlceras ao longo do tempo foi significativamente mais comum no grupo de resina do que no grupo de controlo (P = 0,013). As culturas bacterianas da área da úlcera mais frequentemente tornou-se negativa em 1 mês no grupo de resina. CONCLUSÕES: salve resina tradicional é significativamente mais eficaz no tratamento de úlceras de pressão graves infectados e não infectados do que gazes de polímeros de celulose.

Primary study

Unclassified

A eficácia de um curativo de hidrogel comparação com padrão de gerenciamento de úlceras de pressão.

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Autores Kaya AZ , Turani N , Akyüz M
Revista Journal of wound care
Year 2005
Links Pubmed DOI
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OBJETIVO: Comparar um hidrogel vestir com um regime de cuidados da ferida tópica conservador (gaze com iodopovidona) para o tratamento de úlceras de pressão. MÉTODO: Estudo prospectivo incluindo 27 (24 do sexo masculino e três do sexo feminino) pacientes com lesão na medula espinhal, com um total de 49 úlceras de pressão. As feridas foram escolhidos aleatoriamente para um grupo de tratamento (n = 25,) ou um grupo de controlo (n = 24,). O desfecho primário foi a taxa de cicatrização de feridas (cm2/days). RESULTADOS: As taxas de cura no grupo de tratamento foram maiores do que no grupo controle, embora esta não foi estatisticamente significativa. Cerca de 84% das feridas no grupo de tratamento e de 54% no grupo de controlo epitélio, o que foi estatisticamente significativo (p = 0,04). O tempo de cura significativo no grupo de tratamento foi de 48 dias em comparação com 45 dias para os controlos. CONCLUSÃO: Nossos resultados sugerem que hidrogel curativos oclusivos facilitar a cicatrização, promovendo mais rápida epitelização de úlceras de pressão, quando comparado com o tratamento de feridas conservador.

Primary study

Unclassified

[Randomized prospective trial of gentian violet with dibutyryl cAMP and povidone-iodine with sugar as treatment for pressure sores infected with methicillin-resistant Staphylococcus aureus in elderly patients].

Revista Nihon Ronen Igakkai zasshi. Japanese journal of geriatrics
Year 1997
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A randomized prospective study was done to evaluate the two treatments for pressure sores infected with methicillin-resistant Staphylococcus aureus in elderly patients: Gentian violet plus dibutyryl cAMP (GVcAMP, n = 8) and povidone-iodine plus sugar (IS, n = 11). Age, underlying diseases, and nutritional status did not differ between the two groups. Specimens were obtained biweekly from the pressure sores and were cultured. The percentage of culture dishes with no methicillin-resistant S. aureus was 93% for the patients given GVcAMP, but only 74% for those given IS (p < 0.01). By the 14th week after the start of treatment, the mean area of the pressure sores in the GVcAMP group had decreased to 45% of the area at the start of treatment. In the IS group, the decrease was smaller to 56% of the area before treatment. No local or systemic adverse effects occurred in either group. GVcAMP is useful to treat pressure sores infected with methicillin-resistant S. aureus.

Primary study

Unclassified

A randomized trial of cadexomer iodine in decubitus ulcers.

Revista Journal of the American Geriatrics Society
Year 1983
Links Pubmed DOI
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Thirty-four patients with decubitus ulcers were studied in a randomized trial to compare topical cadexomer iodine with the standard decubitus ulcer treatments used in the participating hospitals. There was a significant reduction of ulcer area with both treatments within three weeks; however, eight of 16 patients treated with cadexomer iodine had a reduction of ulcer area of more than 50 per cent, compared with one of 18 patients treated with the standard treatment (P less than 0.01). Twenty-seven patients continued the same treatment for five more weeks, during which time six in the cadexomer iodine group healed, compared with one in the standard treatment group (P less than 0.05). Cadexomer iodine was superior to the standard treatment in removing pus and debris from the ulcer surface and in reducing pain at the ulcer site. It was found to be easy both to apply and to remove from the ulcers and did not stain skin or clothing. Transient smarting during the first hour after application was reported by three patients, and one patient complained of skin irritation. The results show that cadexomer iodine applied daily has a debriding effect on decubitus ulcers and accelerates healing.

Primary study

Unclassified

Comparison of silver sulfadiazine, povidone-iodine and physiologic saline in the treatment of chronic pressure ulcers.

Autores Kucan JO , Robson MC , Heggers JP , Ko F
Revista Journal of the American Geriatrics Society
Year 1981
Links Pubmed DOI
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The presence of bacteria and local infection is an important factor in the local management of chronic pressure ulcers. For successful closure of the ulcer, the bacterial count should be 10(5) or less per gram of tissue in the granulating wound. In a prospective randomized study of 45 (eventually 40) hospitalized patients, silver sulfadiazine (Silvadene) cream and povidone-iodine (Betadine) solution were compared to physiologic saline for effectiveness in preparing pressure ulcers for closure. Quantitative bacteriologic techniques on tissue biopsy specimens were used for objective evaluation. In 100 percent of the ulcers treated with silver sulfadiazine cream (15 patients) the bacterial counts were reduced to 10(5) or less per gram of tissue within the three-week test period, compared to 78.6 percent in those treated with saline (14 patients) and 63.6 percent in those treated with povidone-iodine solution (11 patients). Moreover, the ulcers treated with silver sulfadiazine cream responded more rapidly, with one-third showing bacterial levels of less than 10(5) within three days, and half within a week.