Meta AnalysisID 4017
蛋白酶调节敷料用于糖尿病足溃疡或下肢静脉溃疡的临床疗效、生活质量及经济结局：一项综述
CRD42017082744
1. Are protease modulating treatments a clinically effective treatment for Diabetic Foot Ulcers (DFU) or Venous/Arterial Leg Ulcers (LU)? 2. Does the use of a protease modulating intervention influence a patient’s quali
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Record Fields
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- Meta Analysis Id
- 4017
- Evidence Id
- 12575
- Core Evidence Id
- 12575
- Source Meta Analysis Id
- 3976
- Herb2 Meta Analysis Id
- HBMA003976
- Crd Id
- CRD42017082744
- Title
- A review of clinical efficacy, quality of life, and economic outcomes associated with use of protease-modulating dressings with diabetic foot ulcer or venous leg ulcer
- Review Question
- 1. Are protease modulating treatments a clinically effective treatment for Diabetic Foot Ulcers (DFU) or Venous/Arterial Leg Ulcers (LU)? 2. Does the use of a protease modulating intervention influence a patient’s quality of life? 3. What is the economic impact of using protease modulating treatments for DFU and LU?
- Study Type Included
- We will include randomised controlled trials, observational trials, database studies and economic modelling. All other study designs, review articles, expert opinion and guidance documents will be excluded.
- Condition Being Studied
- Chronic wounds include leg ulcers, foot ulcers, pressure ulcers, non-healing surgical, burns and trauma wounds. These wounds frequently present as a symptom of an underlying chronic comorbidity such as diabetes, or venous/arterial disease. They may last for many months or even years, causing a burden felt by patients, the healthcare system and the wider economy. Diabetic foot ulcers and ulcers that are caused by underlying venous or arterial disease are an example of long lasting wounds. These patients are also likely to have a recurrence after their wound closes, and the ideal treatment pathway is still uncertain. Many new interventions are available with varying qualities of evidence to support their claims. Wound dressings are a mainstay of treatment; being applied to a wound as part of the wider treatment strategy, which may include compression, debridement, offloading and infection control to achieve full wound closure. Dressings have been categorised by the British National Formulary (BNF) as basic, advanced, antimicrobial, and specialised. Protease-modulating-matrix (PMM) dressings are dressings that have an effect on the matrix-metalloproteases (MMPs) that are present in chronic wounds. PMM is also available in topical form. These interventions are intended to rebalance the levels of MMPs in the wound bed, stimulating healing and improving outcomes. There is uncertainty surrounding the clinical and cost-effectiveness of these interventions, and the benefits felt by patients to their quality of life (QoL). This uncertainty is reinforced by national NG19 and SIGN Guidelines which do not offer any specific guidance on dressings or PMM.
- Participant
- This study will include studies of patients with chronic wounds confirmed to be diabetic, venous or arterial in origin. All other aetiologies of leg ulcers; foot ulcers; pressure ulcers, and non-healing surgical, burns and trauma wounds will be excluded. Methods to diagnose a venous, arterial or diabetic wound may vary and this review will accept any as described by the included the studies.
- Animal
- Human Disease Modelled
- Intervention
- We will include relevant studies and articles that evaluate protease-modulating matrix dressings and topical applications. We will include all versions of these interventions, including, for example, protease-modulating dressings impregnated with other agents, such as antimicrobials (e.g. silver).
- Comparator Control
- Any
- Main Outcome
- Full wound closure (healing), time to closure.
- Outcome Measure
- Additional Outcome
- Absolute or relative Wound Area Reduction (WAR), rate of WAR, adverse events including infection, amputation, gangrene or any other escalation of wound status according to clinical presentation. Any patient reported outcome measures (PROMs) reporting health-related quality of life and pain, or any non-validated patient or clinician satisfaction measure. Resource utilisation data, including frequency of dressing changes, healthcare provider cost, and any financial cost borne by the patient or carers.
- Study Method
- Cost effectiveness, Intervention, Systematic review
- Keyword
- Bandages; Diabetic Foot; Humans; Peptide Hydrolases; Quality of Life; Treatment Outcome; Varicose Ulcer
- Contact
- April Betts [email protected]
- Organisational Affiliation
- Manchester Metropolitan University mmu.ac.uk
- Funding Source
- Manchester Metropolitan University, Urgo Medical UK
- Other Selection Criteria
- Final Publication
- Same Topic Review
- Published Protocol
- Review Type
- Language
- English
- Country
- England
- Review Stage
- Review Ongoing
- First Submission Date
- 2017-12-16
- Registration Date
- 2017-12-18
- Anticipated Start Date
- 2017-12-11
- Anticipated Completion Date
- 2018-07-31
- Title Cn
- 蛋白酶调节敷料用于糖尿病足溃疡或下肢静脉溃疡的临床疗效、生活质量及经济结局：一项综述
- Title En
- A review of clinical efficacy, quality of life, and economic outcomes associated with use of protease-modulating dressings with diabetic foot ulcer or venous leg ulcer
- Bilingual Status
- complete