Fast, strong, and reversible adhesives with dynamic covalent bonds for potential use in wound dressing.

Adhesives typically fall into two categories: those that have high but irreversible adhesion strength due to the formation of covalent bonds at the interface and are slow to deploy, and others that are fast to deploy and the adhesion is reversible but weak in strength due to formation of noncovalent bonds. Synergizing the advantages from both categories remains challenging but pivotal for the development of the next generation of wound dressing adhesives. Here, we report a fast and reversible adhesive consisting of dynamic boronic ester covalent bonds, formed between poly(vinyl alcohol) (PVA) and boric acid (BA) for potential use as a wound dressing adhesive. Mechanical testing shows that the adhesive film has strength in shear of 61 N/cm2 and transcutaneous adhesive strength of 511 N/cm2, generated within 2 min of application. Yet the film can be effortlessly debonded when exposed to excess water. The mechanical properties of PVA/BA adhesives are tunable by varying the cross-linking density. Within seconds of activation by water, the surface boronic ester bonds in the PVA/BA film undergo fast debonding and instant softening, leading to conformal contact with the adherends and reformation of the boronic ester bonds at the interface. Meanwhile, the bulk film remains dehydrated to offer efficient load transmission, which is important to achieve strong adhesion without delamination at the interface. Whether the substrate surface is smooth (e.g., glass) or rough (e.g., hairy mouse skin), PVA/BA adhesives demonstrate superior adhesion compared to the most widely used topical skin adhesive in clinical medicine, Dermabond.

Hydrogel dressings for diabetic foot ulcer: A systematic review and meta-analysis.

AIM: To investigate the differences in utility between conventional dressings and hydrogel dressings for the treatment of diabetic foot ulcer (DFU). METHODS: The PubMed, Embase, Cochrane Library, CNKI, VIP and Wanfang databases were systematically searched up to 21 January 2023. Fixed/random-effect models were used to calculate the odds ratios (ORs) and mean differences (MDs) with 95% confidence intervals (CIs) for the effect size analysis, with heterogeneity determined by I2 statistics. Subgroup analyses of different classes of hydrogel were also conducted. RESULTS: A total of 15 randomized controlled trials with 872 patients were eligible for the present analysis. Compared with conventional dressings, hydrogel dressings significantly improved the healing rate (OR 4.09, 95% CI 2.83 to 5.91), shortened the healing time (MD -11.38, 95% CI -13.11 to -9.66), enhanced granulation formation (MD -3.60, 95% CI -4.21 to -3.00) and epithelial formation (MD -2.82, 95% CI -3.19 to -2.46), and reduced the incidence of bacterial infection (OR 0.10, 95% CI 0.05 to 0.18). CONCLUSION: The meta-analysis showed that hydrogel dressings are more effective in treating DFU compared with conventional dressings.

Effect of hydrocolloid dressings on preventing air leakage when applying negative pressure wound therapy to the perineum, buttocks, and sacrococcygeal region.

Maintaining a vacuum when applying negative pressure wound therapy (NPWT) is the key to its function, which is a challenge in the perineum, buttocks, and sacrococcygeal region. A retrospective cohort study was conducted to assess the effect of hydrocolloid dressings on preventing air leakage when applying NPWT in these regions. There were 61 patients in Group A (without the aid of hydrocolloid dressings) and 65 patients in Group B (with the aid of hydrocolloid dressings). The hydrocolloid dressing-assisted NPWT significantly reduced the incidence of air leakage compared with conventional NPWT placement (24.6% vs. 7.7%; risk ratio, 3.20; 95% confidence interval, 1.24-8.27; p = 0.009), while decreasing the number of open NPWT applications (2.2 vs. 1.7; difference, 0.43; 95% confidence interval, 0.19-0.66; p < 0.001), shortening hospital stays (20.1 vs. 16.1; difference, 4.07; 95% confidence interval, 1.68-6.46; p = 0.01), and reducing the incidence of adverse skin events (18.0% vs. 4.6%; risk ratio, 3.91; 95% confidence interval, 1.14-13.34; p = 0.017). These findings support the routine use of hydrocolloid dressing-assisted NPWT placement in the perineum, buttocks, and sacrococcygeal region.

Fabrication and characterization of a hydrocolloid wound dressing functionalized with human placental derived extracellular matrix for management of skin wounds: An animal study.

BACKGROUND: Functionalization of wound dressing is one of the main approaches for promoting wound healing in skin wound management. In this study, our aim is to fabricate a bio-functionalized hydrocolloid wound dressing. METHODS: The extracellular matrix (ECM) was extracted from human placental tissue. A hydrocolloid film was fabricated using Na-CMC, pectin, gelatin, styrene-isoprene-styrene adhesive, glycerol, and 0.5%-2.5% powdered ECM. A polyurethane film and a release liner were used in the hydrocolloid/ECM films. The mechanical, adhesion, swelling rate, and integrity of the films were investigated. Cell proliferation, adhesion, and migration assays, as well as, SEM and FTIR spectroscopy were also conducted. Macroscopic and microscopic evaluations of wound healing process and formation of blood vessels were conducted in mouse animal models. RESULTS: We successfully fabricated a three-layered ECM-functionalized hydrocolloid dressing with a water vapor transmission rate of 371 g/m2 /day and an adhesion peel strength of 176 KPa. Cellular adhesion, proliferation and migration were promoted by ECM. In the animal tests, ECM-functionalized hydrocolloids significantly improved wound closure and re-epithelialization at days 14 and 21. Also, ECM-functionalized hydrocolloids promoted the formation of hair follicles. CONCLUSIONS: Our findings suggest that ECM could enhance the wound healing properties of hydrocolloid wound dressings. This wound dressing could be considered for application in hard-to-heal acute wounds.

Preventive Effect of Hydrocolloid Dressings on Hypertrophic Scarring of Post-Cesarean Section Wounds: A Randomized Pilot Study.

OBJECTIVE: To determine the prophylactic effect of hydrocolloid dressings on hypertrophic scarring in post-cesarean section wounds. METHODS: Patients who underwent cesarean section (C/S) at the authors' hospital and provided informed consent to participate were randomly assigned to the intervention and control groups. The intervention group commenced applying hydrocolloid dressings to the wound on postoperative day 7 or 8 and continued with weekly dressing changes for 6 months. The control group refrained from any dressing application but was followed up. In each group, the condition of the wound was evaluated 6 and 12 months postoperatively using the Japan Scar Workshop Scar Scale 2015, the Patient and Observer Scar Assessment Scale version 2.0, the modified Vancouver Scar Scale, and patient-reported outcomes. RESULTS: During this period, 135 patients underwent C/S at the authors' institution, and 47 (23 in the intervention group and 24 in the control group) were included in the analysis. In all assessment methods, the intervention group scored lower than the control group at 6 and 12 months after C/S. Twelve months after C/S, hypertrophic scarring (Japan Scar Workshop Scar Scale 2015 score of 6-15) was found in 14 of the 47 (29.8%) patients: 11 of 24 (45.8%) in the control group and 3 of 23 (13.0%) in the intervention group. The intervention's relative risk was 0.623 (95% CI, 0.417-0.930). The risk factor for hypertrophic scarring was midline vertical incision, with an odds ratio of 20.53 (95% CI, 4.18-100.92). CONCLUSIONS: The study reveals that the application of hydrocolloid dressings to wounds reduces the risk of hypertrophic scarring after C/S.

Observation of the Therapeutic Effect of Hydrogel Combined with Alginate Dressings for a Patient with Grade 4 Acute Radiation Dermatitis: A Case Report.

ABSTRACT: In this case report, the authors summarize their experience of using hydrogel combined with alginate dressings in the wound care of a patient with grade 4 acute radiation dermatitis. With the combination of hydrogel and alginate dressings, the authors achieved autolytic debridement of the wound and created a moist healing environment to facilitate wound closure. Hydrogel helps the dressing adhere better to the wound bed, ensuring that it does not easily detach during the wound healing process. It also eliminates the need for traditional adhesive tapes for fixation, thus avoiding damage to the fragile skin in the radiation field.The wound gradually decreased in size from an area of 10 × 12 cm, and exudate decreased continuously. The wound completely healed in 20 days with a total of 17 dressing changes. As the wound gradually healed, the patient's psychological burden decreased and comfort level increased. The patient expressed satisfaction and hope for the gradual healing of the wound.Thus, the treatment of severe acute radiation dermatitis with hydrogel combined with alginate dressings yields remarkable results, aligning the noninvasive, low-adhesive, absorbent, conformable, and comfortable attributes of optimized wound care. This experience provides a practical foundation for wound management in acute radiation dermatitis and supports clinical application and promotion of the approach.

Role of hydrocolloid dressing in preventing face pressure ulcers from non-invasive ventilation and facilitating postoperative wound healing in maxillofacial surgery: A meta-analysis.

Facial pressure ulcers from non-invasive ventilation (NIV) and challenges in wound healing post-maxillofacial surgery are significant concerns in clinical care. This meta-analysis aimed to evaluate the effectiveness of hydrocolloid dressings in these contexts. From a pool of 1135 articles, 8 studies met the inclusion criteria. Hydrocolloid dressings demonstrated a significant reduction in facial pressure ulcers for NIV patients, with lower REEDA scores 1-week postapplication (standardized mean difference [SMD] = -16.7, 95% confidence interval [CI]: -24.26 to -9.15, p < 0.01). In maxillofacial surgery, patients treated with hydrocolloid dressings exhibited improved wound healing and reduced scar formation, evidenced by lower Manchester Scar Scale scores 3 months post-surgery (SMD = -15.46, 95% CI: -20.28 to -10.64, p < 0.01). These findings suggest that hydrocolloid dressings are effective in both preventing NIV-related facial pressure ulcers and enhancing wound healing in maxillofacial surgery.

The role community-based healthcare providers play in managing hard-to-heal wounds.

It is common for community-based healthcare providers (CHPs)-many of whom have not received specialised training in wound care-to deliver initial and ongoing management for various wound types and diverse populations. Wounds in any setting can rapidly transition to a stalled, hard-to-heal wound (HTHW) that is not following a normal healing trajectory. Failure to recognise or address issues that cause delayed healing can lead to increased costs, healthcare utilisation and suffering. To encourage early intervention by CHPs, a panel of wound care experts developed actionable evidence-based recommendations for CHPs delineating characteristics and appropriate care in identifying and treating HTHWs. A HTHW is a wound that fails to progress towards healing with standard therapy in an orderly and timely manner and should be referred to a qualified wound care provider (QWCP) for advanced assessment and diagnosis if not healed or reduced in size by 40%-50% within 4 weeks. HTHWs occur in patients with multiple comorbidities, and display increases in exudate, infection, devitalised tissue, maceration or pain, or no change in wound size. CHPs can play an important initial role by seeing the individual's HTHW risk, addressing local infection and providing an optimal wound environment. An easy-to-follow one-page table was developed for the CHP to systematically identify, evaluate and treat HTHWs, incorporating a basic toolkit with items easily obtainable in common office/clinic practice settings. A flow chart using visual HTHW clinical cues is also presented to address CHPs with different learning styles. These tools encourage delivery of appropriate early interventions that can improve overall healthcare efficiency and cost.

Hydrogel dressings for donor sites of split-thickness skin grafts.

BACKGROUND: Donor site wounds of split-thickness skin grafts can be a major cause of morbidity. Choosing the appropriate dressing for these wounds is crucial to successful healing. Various types of dressing are available, including hydrogel dressings. A review of current evidence is required to guide clinical decision-making on the choice of dressing for the treatment of donor sites of split-thickness skin grafts. OBJECTIVES: To assess the effects of hydrogel dressings on donor site wounds following split-thickness skin grafts for wound healing. SEARCH METHODS: In July 2022 we searched the Cochrane Wounds Specialised Register, CENTRAL, MEDLINE, Embase, and CINAHL EBSCO Plus. We also searched clinical trials registries for ongoing and unpublished studies, and scanned reference lists of relevant included studies as well as reviews, meta-analyses, and health technology reports to identify additional studies. There were no restrictions with respect to language, date of publication, or study setting. SELECTION CRITERIA: Randomised controlled trials (RCTs) comparing hydrogel dressings with other types of dressing, topical treatments or no dressing, or with different types of hydrogel dressings in managing donor site wounds irrespective of language and publication status. DATA COLLECTION AND ANALYSIS: Two review authors independently carried out data extraction, risk of bias assessment using the Cochrane risk of bias tool, RoB 1, and quality assessment according to GRADE methodology. MAIN RESULTS: We included two studies (162 participants) in this review. One study with three arms and 101 participants (15 months' duration) was conducted in a children's hospital, and compared hydrogel dressings in the form of Sorbact with Algisite, an alginate dressing and Cuticerin, a smooth acetate gauze impregnated with water-repellent ointment. Another study with two arms and 61 participants (19 months' duration) was conducted in three surgery departments and compared an octenidine-containing hydrogel dressing with an identical non-antimicrobial hydrogel dressing. We identified no studies that compared hydrogel dressings with another therapy such as a topical agent (a topical agent is a cream, an ointment or a solution that is applied directly to the wound), or no dressing, or a combination of hydrogel dressings and another therapy versus another therapy alone. Both studies were at high risk of attrition bias and the second study was also at unclear risk of selection bias. Amorphous hydrogel dressings versus other types of dressings Amorphous hydrogel dressings may increase time to wound healing when compared with alginate (mean difference (MD) 1.67 days, 95% confidence interval (CI) 0.56 to 2.78; 1 study, 69 participants; low-certainty evidence) or Cuticerin dressings (MD 1.67 days, 95% CI 0.55 to 2.79; 1 study, 68 participants; low-certainty evidence). The effect of amorphous hydrogel dressings compared with other types of dressings is uncertain for pain at the donor site and wound complications, including scarring and itching (very low-certainty evidence). No adverse events were reported in any of the groups. The study did not report health-related quality of life or wound infection. Octenidine-based hydrogel dressing versus octenidine-free hydrogel dressing The effect of octenidine-based hydrogel dressings versus octenidine-free hydrogel dressings is uncertain for time to wound healing (MD 0.40, 95% CI 0.28 to 0.52; 1 study, 41 participants) and wound infection, as the certainty of the evidence is very low. The certainty of the evidence is also very low for adverse events, with two participants in the intervention group and one participant in the comparison group reporting adverse events (risk ratio (RR) 0.58, 95% CI 0.06 to 5.89; 1 study, 41 participants). The study did not report donor site pain, health-related quality of life, or wound complications. AUTHORS' CONCLUSIONS: There is insufficient evidence to determine the effect of hydrogel dressings on donor site wounds of split thickness skin grafts compared with other types of dressings. There is a need for adequately powered and well-designed RCTs, with adequate sample sizes, types of populations and subgroups, types of interventions, and outcomes, that compare hydrogel dressings with other treatment options in the treatment of donor site wounds of split-thickness skin grafts.

Hydrocolloid dressing for the treatment of severe diaper dermatitis.

Diaper dermatitis is a common dermatosis that usually responds to adequate hygiene and topical treatment, but can be a therapeutic challenge. Continuous exposure to feces and urine can cause extensive erosions and pain. The use of hydrocolloid dressings may be helpful in keeping the skin isolated from stool and urine, reducing pain, and enabling skin lesions to heal. We explain an easy technique, utilizing stoma powder and a hydrocolloid dressing, for parents to apply at home.

Performance of Bandage Contact Lens in Patients Post-ocular Surgeries: A Systematic Literature Review.

ABSTRACT: This study systematically reviewed the performance of bandage contact lenses (BCL) such as lotrafilcon A, lotrafilcon B, senofilcon A, balafilcon A, and comfilcon A as postoperative treatment in different ocular surgeries. A systematic search of English and Chinese databases (from inception to December 2021) was conducted for studies reporting the efficacy of BCLs after ocular surgeries. Postoperative symptoms, corneal healing, and visual outcomes were studied. Overall, 38 studies were identified. Bandage contact lens was applied as a postoperative aid in corneal refractive, cataract, and vitrectomy surgeries. Most studies were on photorefractive keratectomy. Reduced postoperative symptoms were observed within 4 hr to 3 days, whereas re-epithelization of the cornea and healing was complete within 3 to 7 days after ocular surgeries except for vitrectomy. In a vitrectomy, greater comfort and improved corneal epithelium were observed on the seventh day after surgery. An improvement in dry eye symptoms was observed at 7 days with considerable benefits observed after 1 month of cataract surgery. These findings indicate that BCLs are effective for improving postoperative symptoms and facilitation of early visual rehabilitation with a wear time of 8 hr to 7 days depending on the type of ocular surgery.

The role of probiotics as wound healers: an overall view.

A wound is an injury to the skin or damage to the body tissue. The healing process differs between various kinds of wounds. Treatment of hard-to-heal (chronic) wounds becomes challenging for healthcare practitioners, especially if patients have underlying health complications such as diabetes. Infection of wounds is another factor that interferes with the healing process and extends its duration. Active research is being conducted into the development of advanced wound dressing technologies. These wound dressings are intended to manage the exudate, reduce bacterial infection and speed up the healing process. Probiotics have been receiving much attention because of their potential application in the clinical field, especially in diagnostics and treatment strategies of various infectious and non-infectious diseases. The host immune-modulatory response and antimicrobial activity of probiotics are expanding their role in the development of improved wound dressing technology.

Use of bioelectric dressings for patients with hard-to-heal wounds: a case report.

There are many types of dressings available for the management of hard-to-heal (chronic) wounds. This case report illustrates the efficacy of bioelectric dressings in healing hard-to-heal wounds in five patients. Of the patients, four had diabetic foot ulcers (DFUs) and one had a surgical site infection. Wounds were examined using the TIMES concept and debridement was carried out if needed. Amorphous hydrogel was used as conduction fluid before the application of the bioelectric wound dressings. The wound was covered with foam dressing and crepe bandage. In this case report, among all five wounds, one wound healed completely while the other four reduced in size, with the presence of more granulation and re-epithelialisation. In this case report, bioelectric wound dressings were effective in managing infection and promoting wound healing.

Experiences implementing hydrocolloid dressings after caesarean section.

AIM: Despite increasing interest in reduction of surgical site infection (SSI) after caesarean section, there is limited evidence around optimal dressing choice. We report the experience of a secondary hospital in regional New Zealand changing from a basic contact dressing to a hydrocolloid dressing over a three-month period, reporting SSI rates, midwifery and nursing experience, and cost. METHOD: A retrospective cohort study of hydrocolloid dressings for caesarean sections over three months, compared with basic contact dressings in caesarean sections in the same period one year previously. We report wound swabs with significant growth; results from a survey sent to midwifery and nursing staff; and cost per dressing, as well as the number of dressing changes before discharge. RESULTS: In the hydrocolloid group (n=94) four patients had significant growth on wound swabs (4.3%, 95% confidence interval (CI): 0-10.6%) compared with six patients in the basic contact group (n=117) (5.1%, 95% CI: 1.0-7.1%). Only 9/20 (45%) midwives reported that they liked the hydrocolloid dressings, compared with 19/21 (90%) liking the basic contact dressings, primarily due to difficulty removing the dressings. When accounting for the number of dressing changes on the ward, the cost per caesarean section was $5.11 NZD for hydrocolloid dressings, compared with $5.72 NZD for basic contact dressings. CONCLUSION: Our initial experience with a change to hydrocolloid dressings showed promising results with regard to SSI rates, as well as a cost reduction. This, however, is to be balanced with dressings that are potentially more difficult to remove, resulting in reduced midwifery and nursing satisfaction.

Nature-Derived Polysaccharide-Based Composite Hydrogels for Promoting Wound Healing.

Numerous innovative advancements in dressing technology for wound healing have emerged. Among the various types of wound dressings available, hydrogel dressings, structured with a three-dimensional network and composed of predominantly hydrophilic components, are widely used for wound care due to their remarkable capacity to absorb abundant wound exudate, maintain a moisture environment, provide soothing and cooling effects, and mimic the extracellular matrix. Composite hydrogel dressings, one of the evolved dressings, address the limitations of traditional hydrogel dressings by incorporating additional components, including particles, fibers, fabrics, or foams, within the hydrogels, effectively promoting wound treatment and healing. The added elements enhance the features or add specific functionalities of the dressings, such as sensitivity to external factors, adhesiveness, mechanical strength, control over the release of therapeutic agents, antioxidant and antimicrobial properties, and tissue regeneration behavior. They can be categorized as natural or synthetic based on the origin of the main components of the hydrogel network. This review focuses on recent research on developing natural polysaccharide-based composite hydrogel wound dressings. It explores their preparation and composition, the reinforcement materials integrated into hydrogels, and therapeutic agents. Furthermore, it discusses their features and the specific types of wounds where applied.

The prevalence of medical adhesive-related skin injury caused by protective dressings among medical staff members during the 2019 coronavirus pandemic in China.

AIM: To explore the prevalence and risk factors for medical adhesive-related skin injury (MARSI) caused by protective dressings among medical staff members during the 2019 coronavirus disease pandemic (COVID-19) in China. MATERIALS AND METHODS: A cross-sectional survey was conducted using a questionnaire. The questionnaire was released through the Questionnaire Star website and was completed online. The prevalence of MARSI was calculated and risk factors were analyzed using a multiple regression model. RESULTS: A total of 414 front-line medical staff members treating COVID-19 patients were enrolled from 46 hospitals across four provinces and two municipalities. Overall, 83.1% used protective medical adhesive dressings applied to the head and face to prevent skin damage from personal protective equipment. The prevalence of MARSI caused by adhesive dressings was 41.9%. By multiple regression analysis, the type of dressing, duration of dressing usage, and pain score were risk factors for MARSI development. CONCLUSIONS: The high prevalence indicates MARSI is common among front-line medical staff members, especially those using hydrocolloid dressings and longer durations of dressing usage. Pain upon dressing removal can be severe and increased the risk of MARSI. We call for paying more attention to MARSI and recommend multisite studies with larger sample sizes to enhance the generalizability of these findings.

Effect of honey dressing in the management of diabetic foot ulcers: A meta-analysis.

A meta-analysis study to assess the effect of honey dressing (HD) in the management of diabetic foot ulcer (DFU). A comprehensive literature examination till January 2023 was implemented and 1794 linked studies were appraised. The picked studies contained 882 subjects with DFUs were in the picked studies' baseline, 424 of them were using HD, and 458 were using a control. Odds ratio (OR) in addition to 95% confidence intervals (CIs) were used to calculate the consequence of HD in the management of DFUs after DFU by the dichotomous and continuous styles and a fixed or random model. The HD applied to DFUs caused a significantly higher wound healing rate (OR, 2.06; 95% CI, 1.45-2.93, P < .001) and lower wound healing time (MD, -10.42; 95% CI, -16.27- -4.58, P < .001) compared with the control. The HD applied to DFUs caused a significantly higher wound healing rate and lower wound healing time compared with the control. Although precautions should be taken when commerce with the consequences since most of the picked studies for this meta-analysis was with low sample sizes.

Effect of hydrocolloid dressings in the management of different grades of pressure wound ulcers in critically ill adult subjects: A meta-analysis.

A meta-analysis was implemented to appraise the effect of hydrocolloid dressings (HCDs) in the management of different grades of pressure wound ulcers (PWUs) in critically ill adult subjects (CIUSs). Inclusive literature research until April 2023 was done, and 969 interconnected researches were revised. The 8 picked researches, enclosed 679 critically ill adult persons at the utilized researchers' starting point; 355 of them were utilizing HCDs, and 324 were controls. Odds ratio (OR) and 95% confidence intervals (CIs) were utilized to appraise the consequences of HCDs in treating CIUSs by the dichotomous approach and a fixed or random model. HCDs had significantly higher PWU complete healing (OR, 2.15; 95% CI, 1.54-3.02, p < 0.001), PWU stage II ulcers complete healing (OR, 2.82; 95% CI, 1.40-5.69, p = 0.004), and PWU stage III ulcers complete healing (OR, 3.73; 95% CI, 1.23-11.35, p = 0.02) compared to control in critically ill adult persons. HCDs had significantly higher PWU complete healing, PWU stage II ulcers complete healing, and PWU stage III ulcers complete healing compared with control in critically ill adult persons. However, caution needs to be taken when interacting with its values since there was a low sample size of most of the chosen research found for the comparisons in the meta-analysis.

Effectiveness of moist dressings in wound healing after surgical suturing: A Bayesian network meta-analysis of randomised controlled trials.

The moist healing theory proves that a moderately moist and airtight environment is conducive to wound healing. However, different moist dressings have different functions. We aim to evaluate the effects of moist dressings on wound healing after surgical suturing and identify superior moist dressings. Randomised controlled trials investigating the application of moist dressings were retrieved from electronic databases, including PubMed, EMBASE, Web of Science, and the Cochrane Library. Wound healing, surgical site infection (SSI), and times of dressing change were assessed. The values of the surface under the cumulative ranking (SUCRA) curve were calculated based on the Bayesian network meta-analysis. Inconsistency tests and funnel plots were applied to analyse the consistency and publication bias. All the analysis complies with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 Checklist and AMSTAR (Assessing the Methodological Quality of Systematic Reviews) Guidelines. Sixteen randomised controlled trials involving 4444 patients were pooled in the network meta-analysis. The ionic silver dressing (SUCRA, 93%) ranked first in wound healing, the metallic silver dressing (SUCRA, 75.9%) ranked first in SSI, and the hydrocolloid dressing (SUCRA, 73.9%) ranked first in times of dressing change. Inconsistency was only observed in wound healing, and no publication bias was observed in this study. The effects of moist dressings are better than gauze dressings in the process of wound healing. The ionic silver dressing is effective in wound healing, whereas the metallic silver dressing is effective in SSI prevention. The hydrocolloid dressing requires the fewest times of dressing change. More high-quality RCTs are required to support the network meta-analysis.

Methods for sampling wound fluid from venous leg ulcers for molecular analyses: A scoping review.

Determining the precise role of molecular factors present in venous leg ulcer exudate will expedite the identification of biomarkers that can optimally guide treatment. However, there is now no standardized approach for collecting, processing and storing wound fluid samples for molecular analyses. This scoping review was conducted to integrate and summarize the multiple types of methods being used currently in studies of venous leg ulcers for collecting, processing and storing wound fluid prior to analysis. PubMed, CINAHL, EMBASE and Scopus databases were searched for eligible studies between 2012 and 2022. Nineteen studies were selected for this scoping review. Five primary methodological categories for wound fluid sampling were identified. The most commonly used collection method involved extracting the fluid from various absorbent materials, and the majority of studies centrifuged wound fluid before storing it at ultra-low temperatures. This review found the wound fluid sampling methods among the included studies to be heterogeneous. Moreover, the data revealed no definitive patterns. There is a critical need to develop standardized wound fluid sampling methods in research to facilitate accurate comparisons of biomarker data across studies and a more rapid determination of biomarkers that can most effectively guide delivery of tailored venous leg ulcer treatments.