Abstract
The purpose of this systematic review and meta-analysis is to assess the clinical effectiveness and safety of the medical hydrogel dressings used in skin wounds and therefore to weight the evidence for their clinical application. PubMed/Medline (1980–2019), Cochrane Library (1980–2019), ClinicalTrials.gov, Cochrane CENTRAL, Chinese Journal Full-text Database (CNKI, 1994–2019), and China Biomedy Medicine disc (CBM, 1978–2019), Chinese Scientific Journal Database (VIP, 1989–2019), and Wanfang Database (WFDATA, 1980–2019) were searched to identify relevant clinical trials and studies. Forty-three studies that assessed hydrogel vs. non-hydrogel dressings were identified. Compared to the latter, hydrogel dressings associated with a significantly shortened healing time of degree II burn (superficial and deep) wounds, diabetic foot ulcers, traumatic skin injuries, radioactive skin injuries, dog bites, and body surface ulcers. In addition, hydrogel dressing obviously increased the cure rate of diabetic foot ulcers, surgical wounds, dog bites, and body surface ulcers. Moreover, hydrogel dressing significantly relieved pain in degree II burn (superficial and deep) wounds, traumatic skin injuries, and laser treatment-induced wounds. However, no significant differences obtained between hydrogel and non-hydrogel dressings in the healing time of surgical wounds, the cure rate of inpatients' pressure ulcers, and phlebitis ulcers. This comprehensive systematic review and meta-analysis of the available evidence reveals that the application of hydrogel dressings advances the healing of various wound types and effectively alleviates the pain with no severe adverse reactions. These results strongly indicate that hydrogel products are effective and safe in wound management.
Highlights
Skin is the largest human organ as it reaches almost 10% of the total body mass (Grice et al, 2009) and acts as a key protective barrier against the outside environment
43 studies were kept after screening titles, abstracts, and full-texts (Figure 1), including 29 randomized controlled trials (RCTs) and 14 clinical controlled trials (CCTs) with a total of 3,521 patients
The results showed that on average the wound healing time of the hydrogel dressings group was shortened by 2.87 days as compared with the control group and that the difference had a high statistical significance (MD = −2.87, 95% CI: −3.35 to −2.38, P < 0.00001)
Summary
Skin is the largest human organ as it reaches almost 10% of the total body mass (Grice et al, 2009) and acts as a key protective barrier against the outside environment. The human body heal skin injuries via a set of complex and interactive processes that include hemostasis, inflammation, proliferation, and remodeling. This healing process can be impaired by Effectiveness and Safety of Hydrogel various local and systemic factors causing more severe complications and a lower quality of life (Nourian Dehkordi et al, 2019). The ideal advanced wound dressing should provide and maintain a moist environment, adequate gaseous exchange, and thermal insulation in the absence of toxic contaminants; it should protect against secondary infections, induce tissue regeneration, relieve wound pain, and promote wound healing quality; it should be elastic, non-antigenic, and allow to manage wound exudate (Purna and Babu, 2000). Considering all the just mentioned factors, hydrogel products have the capacity to act as promising candidates as wound dressings for applications in clinical settings (Qu et al, 2018)
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