Silver-Containing Dressings for Diabetic Foot Ulcers: A Systematic Review and Meta-Analysis

Introduction: Diabetic foot ulcer (DFU) is a serious complication of diabetes mellitus that can lead to foot infection, lower limb amputation, and even death. Considering the financial and psychosocial burden following DFUs, it is necessary to evaluate existing treatments and identify the best possible treatments. In this systematic review and meta-analysis, we assessed the healing effects of silver-containing dressing in comparison to silver-free dressings in wound care for DFUs.Methods: We searched PubMed, Embase, Web of Science, and Cochrane central for potential relevant literature. Two independent reviewers screened all the titles and abstracts, and then the full-text of remaining articles. The following data were extracted from the final eligible studies: general information, baseline characteristics of the participants, interventions, and outcomes of interest. The outcome of Wound healing, Hospital length of stay (LOS), Adverse events and Time to heal were evaluated by random-effects meta-analysis in Stata software, version 13.Results: By the end of the screening, eleven studies including 639 subjects were eligible for analysis. The result showed that, the Wound healing [OR: 2.417 (1.570-3.720); P< 0.0001] and Hospital LOS [mean diff: -11.265 (-20.101 to -2.429); P=0.012] were significantly different in the Silver-containing dressings compared with the comparison group. The adverse events [OR: 0.646 (0.231 to 1.809); P=0.406] and Time to heal [mean diff: 1.533 (-8.465 to 11.531); P=0.764] were similar in two groups, and there were no significant differences between two groups.Conclusion: The modern silver dressings seem to be beneficial to patients with diabetic foot ulcers, giving a higher wound healing frequency as well as shorter hospital length of stay.