Use of Oxidized Regenerated Cellulose/Collagen Matrix in Chronic Diabetic Foot Ulcers: A Systematic Review.

Abstract

Diabetic wounds that do not heal completely usually exhibit inflammatory markers, increased protease activity, and reduced levels of growth factors and cell count. A systematic review was performed to determine whether there is enough evidence to support the use of an oxidized regenerated cellulose/collagen matrix (ORC+C) to treat diabetic foot ulcers (DFUs). Study authors analyzed randomized controlled trials (RCTs) on ORC+C dressings for the treatment of DFUs. A literature search was conducted for all available reports of relevant studies published in journals indexed in PubMed, LILACS, and SciELO databases. There were no restrictions based on date of publication. A population-intervention-comparison-outcome framework was built on MeSH terms and keywords. Two independent researchers analyzed all articles for data collection and used the Cochrane Collaboration tool for risk-of-bias assessment. At first, 316 related studies were located in the databases. After evaluating these studies for methodological similarities, only 3 were considered eligible for the review. One RCT was considered at high risk of bias. Results from this meta-analysis of 2 studies showed no significant improvement in wound healing rates of DFUs when ORC+C was compared with standard wound care. Because of several methodology flaws in the reviewed studies, these results suggest that there is currently no research evidence to suggest that the use of ORC+C improves wound healing rates of DFUs. Additional research with high-quality RCTs focused on diabetic ulcers is necessary.