e-space
Manchester Metropolitan University's Research Repository

A Systematic Review of Clinical Efficacy Associated with use of Protease-Modulating Interventions with Diabetic Foot Ulcer or Venous Leg Ulcer

Yeowell, Gillian and Betts, April and Odeyemi, Isaac and Fatoye, Francis (2018) A Systematic Review of Clinical Efficacy Associated with use of Protease-Modulating Interventions with Diabetic Foot Ulcer or Venous Leg Ulcer. In: ISPOR 2018, 19 May 2018 - 23 May 2018, Baltimore, USA.

[img]
Preview

Download (1MB) | Preview

Abstract

OBJECTIVES: Diabetic foot ulcers (DFUs) or leg ulcers (LUs) of venous, arterial or mixed origin can cause a considerable burden to a patient and healthcare provider, taking a long time to heal and requiring frequent interventions. Dressings are a mainstay of treatment with countless options for a Healthcare Provider. Protease-modulating matrix (PMM) interventions are an alternative to basic or other advanced dressings. A systematic review was undertaken to assess the clinical effectiveness of PMM interventions for DFUs and LUs. METHODS: A systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines. An online database search, and consultation with experts and manufacturers identified the literature. Databases searched included: Centre Reviews and Dissemination (CRD) York Database, Cochrane Library, Medline (PubMed), National Institute for Health and Clinical Excellence Evidence Search, Science Direct/Scopus. Two researchers performed data extraction with a third consulted in case of any discrepancies. A narrative synthesis of results and critical appraisal of included studies was performed. RESULTS: A total of 283 records were identified by literature searching. After initial screening of titles and abstracts, 215 full text articles were judged against pre-defined inclusion and exclusion criteria. Six randomised controlled trials and 2 observational studies were included in the review. A total of 1310 patients were included in this study. The three VLU RCTs included a total of 377 patients, and the DFU studies included 933 patients. Healing was the most frequently reported outcome, followed by wound area reduction. A meta-analysis was not possible given the heterogeneity of the included studies. CONCLUSIONS: This review provides some evidence that PMM interventions have a clinical benefit on wound healing outcomes; however, there were several methodological issues with the studies included. New evidence shows promising results for the treatment of DFUs involving protease modulation by sucrose octasulfate dressings.

Impact and Reach

Statistics

Downloads
Activity Overview
10Downloads
25Hits

Additional statistics for this dataset are available via IRStats2.

Actions (login required)

Edit Item Edit Item