Zhongguo quanke yixue (Nov 2022)

Selection and Application of Wound Dressings in Diabetic Foot Disease: Recommendations from Evidence-based Guidelines

  • LUO Yixin, YANG Chuan, LIU Xingzhou, MAI Lifang, WEI Xiaocui, JIANG Zhuyi

DOI
https://doi.org/10.12114/j.issn.1007-9572.2022.0389
Journal volume & issue
Vol. 25, no. 32
pp. 3990 – 3998

Abstract

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Background Local wound management is a key part in the management of diabetic foot ulcers (DFUs), and dressings are one major tool. There are no specific guidelines on dressing selection for DFUs, and it is urgently needed to integrate relevant contents scattered in major comprehensive guidelines. Objective Practice guidelines related to the management of diabetic foot were searched and reviewed, and entries related to dressing selection or application were extracted for evidence synthesis to inform clinical interventions. Methods Published clinical practice guidelines about diabetes management were searched from diabetes websites and electronic literature databases, the search period was from January 2012 to November 2021, and screened according to inclusion and exclusion criteria, then their methodological quality was evaluated, and evidence related to dressing selection and application in which was translated, extracted and synthesized. Results Ten guidelines published between 2012 and 2020 were included, with overall high quality and high consistency between reviewers. Then a table of recommendations for selection and application of wound dressings for diabetic foot disease was developed by comprehensively summarizing relevant evidence extracted from the guidelines (evidence from eight guidelines in foreign languages was first translated into Chinese before being extracted) . Conclusion The evidence selected from the guidelines involves wound characteristics, moisture healing, periwound skin management, patient preference, and cost. Among them, wound characteristics should be seriously considered in the selection of dressings for DFUs. Most of the recommendations are about the treatment of wound exudate condition and the presence or absence of infection. However, there are fewer recommendations for basal tissue types, especially gangrene wounds.

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