Meta-analysis on the safety and efficacy of different dressings in the treatment of diabetic foot ulcers.

Abstract

Introduction: Diabetic foot ulcers (DFU) are a common and severe complication of diabetes, associated with high morbidity, infection risk, and amputation rates. Various dressings have been applied in clinical practice, yet their comparative safety and efficacy remain unclear. This study aimed to systematically evaluate different dressings for DFU treatment through meta-analysis.

Content: Relevant studies from Chinese and English databases were retrieved and analyzed. A total of 25 studies involving 2,421 patients were included. Dichotomous data analysis showed that the experimental group had a significantly higher complete wound healing rate than the control group (OR=4.62, 95 % CI: 3.10-6.90, p<0.01), a significantly lower incidence of wound infection (OR=0.63, 95 % CI: 0.43-0.93, p=0.02), and no significant difference in amputation rate (OR=0.62, 95 % CI: 0.34-1.14, p=0.12). Continuous data analysis indicated that the experimental group had higher wound healing scores (MD=25.77, 95 % CI: 2.33-49.20, p=0.03), greater ulcer area reduction (MD=27.96, 95 % CI: 21.93-34.00, p<0.01), and shorter healing time (MD=-11.41, 95 % CI: -14.35 to -8.47, p<0.01). Meta-regression analysis suggested that publication year, blinding, and outcome indicators contributed to heterogeneity (p<0.05).

Summary: Activated carbon cloth (ACC), negative pressure wound therapy (NPWT), and olive oil dressings demonstrated favorable safety and efficacy, although each has distinct advantages. Clinical selection should therefore be individualized according to patient conditions and wound characteristics.

Outlook: Future studies with larger sample sizes and higher methodological quality are needed to further validate these findings and reduce heterogeneity, thereby providing more robust evidence for clinical decision-making.