Comparative efficacy of nine different dressings in healing diabetic foot ulcer: A Bayesian network analysis

Background There is a wide variety of dressings currently available for the treatment of diabetic foot ulcers (DFUs). Because of a lack of evidence from head-to-head randomized controlled trials (RCTs), the relative effects of these dressings in DFU patients remain unclear. This study compared the efficacy of nine dressings in healing DFU. Methods A literature search was performed of the MEDLINE (PubMed), EMBASE and Cochrane Central Register of Controlled Trials (CENTRAL) databases. Reports published from 1993 to 2017 focusing on dressings for healing DFU were identified. Results Twenty-one RCTs, with a total of 2159 patients, were included in the present study. Bayesian network analysis showed that amniotic membrane dressings were superior to alginate, basic wound contact, foam, honey-impregnated, hydrocolloid, and iodine-impregnated dressings. Hydrogel dressings were better than basic wound contact dressings. Other dressings showed no significant differences. According to the probability of ranking results, amniotic membrane and hydrogel dressings are preferred for healing DFUs. Conclusions The nine dressings evaluated in this study had different advantages in promoting the healing of DFU, but most differences among the dressings were not significant. According to the analysis of rank probability, amniotic membrane and hydrogel dressings are the most advantageous in terms of promoting DFU healing. It is recommended that the most suitable dressing should be selected taking into consideration exudate control, comfort, and cost.