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Jan Apelqvist

Physician

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Prospective randomized controlled study of Hydrofiber(R) dressing containing ionic silver or calcium alginate dressings in non-ischaemic diabetic foot ulcers.

Author

  • E B Jude
  • Jan Apelqvist
  • M Spraul
  • J Martini

Summary, in English

Aims Diabetic foot ulcers (DFUs) are at risk of infection and impaired healing, placing patients at risk of lower extremity amputation. DFU care requires debridement and dressings. A prospective, multicentre study compared clinical efficacy and safety of AQUACEL (R) Hydrofiber (R) dressings containing ionic silver (AQAg) with those of Algosteril (R) calcium alginate (CA) dressings in managing out-patients with Type 1 or 2 diabetes mellitus and non-ischaemic Wagner Grade 1 or 2 DFUs. Methods Patients stratified by antibiotic use on enrolment were randomly assigned to similar protocols including off-loading, AQAg (n = 67) or CA (n = 67) primary dressings and secondary foam dressings for 8 weeks or until healing. Clinical efficacy measures were healing outcomes and primarily healing speed. Adverse events were recorded. Results AQAg and CA groups were comparable at baseline. All ulcer healing outcomes improved in both groups. The mean time to healing was 53 days for AQAg ulcers and 58 days for CA ulcers (P = 0.34). AQAg-treated ulcers reduced in depth nearly twice as much as CA-treated ulcers (0.25 cm vs. 0.13 cm; P = 0.04). There was more overall ulcer improvement and less deterioration in AQAg subjects (P = 0.058), particularly in the subset initially using antibiotics (P = 0.02). Safety profiles of both groups were similar. Conclusion When added to standard care with appropriate off-loading, AQAg silver dressings were associated with favourable clinical outcomes compared with CA dressings, specifically in ulcer depth reduction and in infected ulcers requiring antibiotic treatment. This study reports the first significant clinical effects of a primary wound dressing containing silver on DFU healing.

Department/s

  • Genomics, Diabetes and Endocrinology

Publishing year

2007

Language

English

Pages

280-288

Publication/Series

Diabetic Medicine

Volume

24

Issue

3

Document type

Journal article

Publisher

Wiley-Blackwell

Topic

  • Endocrinology and Diabetes

Keywords

  • antibiotic
  • alginate
  • diabetes
  • foot ulcer
  • Hydrofiber (R) dressing
  • silver
  • synergy

Status

Published

Research group

  • Genomics, Diabetes and Endocrinology

ISBN/ISSN/Other

  • ISSN: 1464-5491