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Prospective randomized controlled study of Hydrofiber dressing containing ionic silver or calcium alginate dressings in non-ischaemic diabetic foot ulcers.
Diabet Med 2007; 24(3):280-8DM

Abstract

AIMS

Diabetic foot ulcers (DFUs) are at risk of infection and impaired healing, placing patients at risk of lower extremity amputation. DFU care requires debridement and dressings. A prospective, multicentre study compared clinical efficacy and safety of AQUACEL Hydrofiber dressings containing ionic silver (AQAg) with those of Algosteril calcium alginate (CA) dressings in managing out-patients with Type 1 or 2 diabetes mellitus and non-ischaemic Wagner Grade 1 or 2 DFUs.

METHODS

Patients stratified by antibiotic use on enrolment were randomly assigned to similar protocols including off-loading, AQAg (n = 67) or CA (n = 67) primary dressings and secondary foam dressings for 8 weeks or until healing. Clinical efficacy measures were healing outcomes and primarily healing speed. Adverse events were recorded.

RESULTS

AQAg and CA groups were comparable at baseline. All ulcer healing outcomes improved in both groups. The mean time to healing was 53 days for AQAg ulcers and 58 days for CA ulcers (P = 0.34). AQAg-treated ulcers reduced in depth nearly twice as much as CA-treated ulcers (0.25 cm vs. 0.13 cm; P = 0.04). There was more overall ulcer improvement and less deterioration in AQAg subjects (P = 0.058), particularly in the subset initially using antibiotics (P = 0.02). Safety profiles of both groups were similar.

CONCLUSION

When added to standard care with appropriate off-loading, AQAg silver dressings were associated with favourable clinical outcomes compared with CA dressings, specifically in ulcer depth reduction and in infected ulcers requiring antibiotic treatment. This study reports the first significant clinical effects of a primary wound dressing containing silver on DFU healing.

Authors+Show Affiliations

Department of Diabetic Medicine, Tameside General Hospital, Ashton-Under-Lyne, UK. edward.jude@tgh.nhs.ukNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17305788

Citation

Jude, E B., et al. "Prospective Randomized Controlled Study of Hydrofiber Dressing Containing Ionic Silver or Calcium Alginate Dressings in Non-ischaemic Diabetic Foot Ulcers." Diabetic Medicine : a Journal of the British Diabetic Association, vol. 24, no. 3, 2007, pp. 280-8.
Jude EB, Apelqvist J, Spraul M, et al. Prospective randomized controlled study of Hydrofiber dressing containing ionic silver or calcium alginate dressings in non-ischaemic diabetic foot ulcers. Diabet Med. 2007;24(3):280-8.
Jude, E. B., Apelqvist, J., Spraul, M., & Martini, J. (2007). Prospective randomized controlled study of Hydrofiber dressing containing ionic silver or calcium alginate dressings in non-ischaemic diabetic foot ulcers. Diabetic Medicine : a Journal of the British Diabetic Association, 24(3), pp. 280-8.
Jude EB, et al. Prospective Randomized Controlled Study of Hydrofiber Dressing Containing Ionic Silver or Calcium Alginate Dressings in Non-ischaemic Diabetic Foot Ulcers. Diabet Med. 2007;24(3):280-8. PubMed PMID: 17305788.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prospective randomized controlled study of Hydrofiber dressing containing ionic silver or calcium alginate dressings in non-ischaemic diabetic foot ulcers. AU - Jude,E B, AU - Apelqvist,J, AU - Spraul,M, AU - Martini,J, AU - ,, PY - 2007/2/20/pubmed PY - 2007/8/19/medline PY - 2007/2/20/entrez SP - 280 EP - 8 JF - Diabetic medicine : a journal of the British Diabetic Association JO - Diabet. Med. VL - 24 IS - 3 N2 - AIMS: Diabetic foot ulcers (DFUs) are at risk of infection and impaired healing, placing patients at risk of lower extremity amputation. DFU care requires debridement and dressings. A prospective, multicentre study compared clinical efficacy and safety of AQUACEL Hydrofiber dressings containing ionic silver (AQAg) with those of Algosteril calcium alginate (CA) dressings in managing out-patients with Type 1 or 2 diabetes mellitus and non-ischaemic Wagner Grade 1 or 2 DFUs. METHODS: Patients stratified by antibiotic use on enrolment were randomly assigned to similar protocols including off-loading, AQAg (n = 67) or CA (n = 67) primary dressings and secondary foam dressings for 8 weeks or until healing. Clinical efficacy measures were healing outcomes and primarily healing speed. Adverse events were recorded. RESULTS: AQAg and CA groups were comparable at baseline. All ulcer healing outcomes improved in both groups. The mean time to healing was 53 days for AQAg ulcers and 58 days for CA ulcers (P = 0.34). AQAg-treated ulcers reduced in depth nearly twice as much as CA-treated ulcers (0.25 cm vs. 0.13 cm; P = 0.04). There was more overall ulcer improvement and less deterioration in AQAg subjects (P = 0.058), particularly in the subset initially using antibiotics (P = 0.02). Safety profiles of both groups were similar. CONCLUSION: When added to standard care with appropriate off-loading, AQAg silver dressings were associated with favourable clinical outcomes compared with CA dressings, specifically in ulcer depth reduction and in infected ulcers requiring antibiotic treatment. This study reports the first significant clinical effects of a primary wound dressing containing silver on DFU healing. SN - 0742-3071 UR - https://www.unboundmedicine.com/medline/citation/17305788/Prospective_randomized_controlled_study_of_Hydrofiber_dressing_containing_ionic_silver_or_calcium_alginate_dressings_in_non_ischaemic_diabetic_foot_ulcers_ L2 - https://doi.org/10.1111/j.1464-5491.2007.02079.x DB - PRIME DP - Unbound Medicine ER -