title: Effectiveness of advanced versus conventional wound dressings on healing of chronic wounds: systematic review and meta-analysis.
abstract: BACKGROUND
  Wound dressings are essential in the treatment of chronic wounds and should be selected on valid and recent evidence.
  
  
  OBJECTIVE
  Effectiveness of advanced compared to conventional dressings for chronic wound healing.
  
  
  METHODS
  Comprehensive literature search, systematic review and meta-analyses of the results of advanced dressing studies on chronic wound treatment. Comprehensiveness and coverage of all relevant studies is the most striking difference in relation to other meta-analyses and systematic reviews.
  
  
  RESULTS
  The mean odds ratio of complete healing was 1.52 favouring advanced over conventional dressings in 65 controlled trials. In 287 study conditions including uncontrolled studies, mean odds were 0.97 (advanced dressings/controlled studies), 0.77 (conventional/controlled) and 0.47 (advanced/uncontrolled). The overall healing rate was 33%. When causal treatment was applied, a reduced effect was observed. The consideration of all types of chronic wounds, advanced wound dressings and studies resulted in more study effects, more reliable estimates of mean effects and more statistical power. These differences in the design are likely to explain the differences in the meta-analytic results.
  
  
  CONCLUSIONS
  A general superiority of advanced dressings on complete healing was shown. The generalizability of the results is limited by the methodological and report quality within studies identified, unexplained heterogeneity in study effects and possibly by publication bias.
authors.affiliation: German Center for Health Services Research in Dermatology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. k.heyer @ uke.de
authors.forename: K
authors.initials: K
authors.lastname: Heyer
authors.forename: M
authors.initials: M
authors.lastname: Augustin
authors.forename: K
authors.initials: K
authors.lastname: Protz
authors.forename: K
authors.initials: K
authors.lastname: Herberger
authors.forename: C
authors.initials: C
authors.lastname: Spehr
authors.forename: S J
authors.initials: SJ
authors.lastname: Rustenbach
mesh_terms: D001458:Bandages; D002908:Chronic Disease; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D014945:Wound Healing / Q000502:physiology; D014947:Wounds and Injuries / Q000628:therapy*