Impact of Silver Dressings on Wound Healing Rate in Patients with Lower Extremity Ulcers: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Abstract

OBJECTIVE The ulcers of lower extremities, both venous and diabetic, impose a massive burden on sufferers globally. This meta-analysis evaluates the efficacy of silver dressings in improving healing rate of these ulcers. METHODS We carried out comprehensive searches in PubMed, Embase, Web of Science, the Cochrane Library, and China National Knowledge Internet (CNKI) up to March 2024. Two reviewers independently screened the study and extracted data. While the primary outcome was wound healing rate, secondary outcomes included wound healing area and recurrence rate. Data were analyzed using Stata 16.0. software. RESULTS A total of 18 studies involving 1825 participants were included. Silver dressings demonstrated statistically significant effects in improving healing rates for diabetic foot ulcers (DFU) (OR 2.14, 95% CI: 1.52, 3.00, p = 0.00), whereas the effects were not statistically significant for venous leg ulcers (VLU) (OR 1.32, 95% CI: 0.97, 1.78, p = 0.07). Silver dressings also reduced ulcer area by 27.44 cm2 (95% CI 6.96 to 47.92) and recurrence rate of 45% (95% CI 0.11 to 1.79). Subgroup analysis revealed that the Asia-Pacific region and treatments of six weeks or less exhibited higher healing rates than their respective counterparts, although there was no statistical significance. CONCLUSIONS This study indicated a statistically significant benefit of the treatment for DFU. However, the effect on VLU, though positive, did not reach statistical significance. This distinction should be considered in clinical application and further research.