• Guillaume Chaby, Patricia Senet, Michel Vaneau, Philippe Martel, Jean-Claude Guillaume, Sylvie Meaume, Luc Téot, Clélia Debure, Anne Dompmartin, Hélène Bachelet, Hervé Carsin, Véronique Matz, Jean Louis Richard, Jean Michel Rochet, Nathalie Sales-Aussias, Anne Zagnoli, Catherine Denis, Bernard Guillot, and Olivier Chosidow.
• Department of Dermatology, Centre Hospitalier Universitaire d'Amiens, Amiens, France.
• Arch Dermatol. 2007 Oct 1;143(10):1297-304.

ObjectiveTo critically review the literature on the efficacy of modern dressings in healing chronic and acute wounds by secondary intention.Data SourcesSearch of 3 databases (MEDLINE, EMBASE, and the Cochrane Controlled Clinical Trials Register) from January 1990 to June 2006, completed by manual research, for articles in English and in French.Study SelectionThe end points for selecting studies were the rate of complete healing, time to complete healing, rate of change in wound area, and general performance criteria (eg, pain, ease of use, avoidance of wound trauma on dressing removal, ability to absorb and contain exudates). Studies were selected by a single reviewer. Overall, 99 studies met the selection criteria (89 randomized controlled trials [RCTs], 3 meta-analyses [1 of which came from 1 of the selected systematic reviews], 7 systematic reviews, and 1 cost-effectiveness study).Data ExtractionThe RCTs, meta-analyses, and cost-effectiveness studies were critically appraised by 2 reviewers to assess the clinical evidence level according to a modification of Sackett's 1989 criteria. Ninety-three articles were finally graded.Data SynthesisWe found no level A studies, 14 level B studies (11 RCTs and 3 meta-analyses), and 79 level C studies. Hydrocolloid dressings proved superior to saline gauze or paraffin gauze dressings for the complete healing of chronic wounds, and alginates were better than other modern dressings for debriding necrotic wounds. Hydrofiber and foam dressings, when compared with other traditional dressings or a silver-coated dressing, respectively, reduced time to healing of acute wounds.ConclusionsOur systematic review provided only weak levels of evidence on the clinical efficacy of modern dressings compared with saline or paraffin gauze in terms of healing, with the exception of hydrocolloids. There was no evidence that any of the modern dressings was better than another, or better than saline or paraffin gauze, in terms of general performance criteria. More wound care research providing level A evidence is needed.

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