Effectiveness of silver dressings in the treatment of diabetic foot ulcers: a systematic review and meta-analysis

Abstract

Objective: Silver dressings have been used in the treatment of diabetic foot ulcers (DFUs). However, meta-analyses examining their effectiveness is lacking. Therefore, this meta-analysis evaluates the effectiveness of silver dressings on DFU healing. Method: Various databases were searched for randomised controlled trials (RCTs) of silver dressing applied to DFUs. Results: A total of seven studies involving 650 patients were identified for inclusion in the meta-analysis. The odds ratio (OR) for silver dressing improving wound healing rate, complete healing time, ulcer-related in-hospital time and infection resolution rate were: 4.02 (95% confidence interval [CI]: 2.25–7.17; p<0.01); 2.81 (95% CI: –3.33––2.29; p<0.01); 12.13 (95% CI:–20.64––3.62; p<0.01); and 7.36 (95% CI: 1.58–34.22; p=0.01), respectively. The OR on ulcer area reduction was 8.60 (95% CI:–8.93–26.12; p=0.34) indicating no significant effect. Conclusion: The results of this meta-analysis showed that silver dressings enhance DFU healing rate, shorten the time to complete healing, shorten in-hospital duration, and improve infection resolution rate, while having no significant effect on reduction of ulcer area. Large-scale, multicentre, rigorously designed RCTs are recommended for future investigation to justify the beneficial effects of silver dressings on DFU healing.