目的:评估银和碘敷料对愈合时间的影响,治愈率,渗出物量,疼痛和抗感染功效。
方法:系统评价和荟萃分析。
方法:包括PubMed、科克伦图书馆,Embase,截至2024年5月,对WebofScience和CINAHL进行了调查。
方法:比较银和碘敷料对人类伤口愈合的随机对照试验。
方法:使用建议分级评估证据确定性,评估,发展,和评价方法。数据提取由两名审查人员独立完成,使用Cochrane工具评估偏倚风险。进行叙事合成以评估银和碘敷料对愈合时间的影响,治愈率,疼痛,渗出物量和抗感染疗效。使用ReviewManagerV.5.4进行荟萃分析,计算愈合时间的标准化平均差异和速率的相对风险,以量化治疗的影响。
结果:纳入17项研究(18篇)。荟萃分析表明,与碘敷料相比,银敷料显着缩短了愈合时间(SMD=-0.95,95%CI-1.62至-0.28,I2=92%,p=0.005,中等质量证据),在提高治愈率方面没有显着差异(RR=1.29,95%CI0.90至1.85,I2=91%,p=0.16,低质量证据)。基于低质量的证据,对于渗出物量(3/17),在减少渗出物量方面,66.7%(2/3)的研究比碘更喜欢银敷料。疼痛(7/17)57.1%(4/7)的研究报告银和碘敷料之间没有显着差异,而42.9%(3/7)的研究表明银质敷料能更好地缓解疼痛。抗感染疗效(11/13),54.5%(6/11)的研究表明银和碘敷料是等效的,而36.4%(4/11)的人建议对银具有更大的抗菌功效。
结论:银敷料,显示出与碘敷料相当的愈合率,显着减少愈合时间,这表明它们在伤口护理中具有优越的辅助作用.
■CRD42020199602。
OBJECTIVE: To evaluate the effects of silver and iodine dressings on healing time, healing rate, exudate amount, pain and anti-infective efficacy.
METHODS: Systematic review and meta-analysis.
METHODS: Databases including PubMed, Cochrane Library, Embase, Web of Science and CINAHL were surveyed up to May 2024.
METHODS: Randomised controlled trials comparing silver and iodine dressings on wound healing in humans.
METHODS: Evidence certainty was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation approach. Data extraction was done independently by two reviewers, with the risk of bias assessed using the Cochrane tool. Narrative synthesis was performed to evaluate the effects of silver and iodine dressings on healing time, healing rate, pain, exudate amount and anti-infective efficacy. Meta-analysis using Review Manager V.5.4 calculated standardised mean differences for healing time and relative risks for rate to quantify the impacts of the treatments.
RESULTS: 17 studies (18 articles) were included. The meta-analysis indicated that silver dressings significantly reduced healing time compared with iodine dressings (SMD=-0.95, 95% CI -1.62 to -0.28, I2=92%, p=0.005, moderate-quality evidence), with no significant difference in enhancing healing rate (RR=1.29, 95% CI 0.90 to 1.85, I2=91%, p=0.16, low-quality evidence). Based on low-quality evidence, for exudate amount (3/17), 66.7% (2/3) of the studies favoured silver dressings over iodine in reducing exudate volume. For pain (7/17), 57.1% (4/7) of the studies reported no significant difference between silver and iodine dressings, while 42.9% (3/7) studies indicated superior pain relief with silver dressings. For anti-infective efficacy (11/13), 54.5% (6/11) of the studies showed equivalence between silver and iodine dressings, while 36.4% (4/11) suggested greater antibacterial efficacy for silver.
CONCLUSIONS: Silver dressings, demonstrating a comparable healing rate to iodine dressings, significantly reduce healing time, suggesting their potential as a superior adjunct in wound care.
UNASSIGNED: CRD42020199602.