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Use of Oxidized Regenerated Cellulose/Collagen Matrix in Chronic Diabetic Foot Ulcers: A Systematic Review

Chicone, Gisele, MS, RN, CWOCN; de Carvalho, Viviane, Fernandes, PhD, RN; Paggiaro, André, Oliveira, PhD, MD

doi: 10.1097/01.ASW.0000527297.95688.76
Features: Original Investigation

OBJECTIVE: Diabetic wounds that do not heal completely usually exhibit inflammatory markers, increased protease activity, and reduced levels of growth factors and cell count. A systematic review was performed to determine whether there is enough evidence to support the use of an oxidized regenerated cellulose/collagen matrix (ORC+C) to treat diabetic foot ulcers (DFUs).

METHODS: Study authors analyzed randomized controlled trials (RCTs) on ORC+C dressings for the treatment of DFUs. A literature search was conducted for all available reports of relevant studies published in journals indexed in PubMed, LILACS, and SciELO databases. There were no restrictions based on date of publication. A population-intervention-comparison-outcome framework was built on MeSH terms and keywords. Two independent researchers analyzed all articles for data collection and used the Cochrane Collaboration tool for risk-of-bias assessment.

RESULTS: At first, 316 related studies were located in the databases. After evaluating these studies for methodological similarities, only 3 were considered eligible for the review. One RCT was considered at high risk of bias. Results from this meta-analysis of 2 studies showed no significant improvement in wound healing rates of DFUs when ORC+C was compared with standard wound care.

CONCLUSIONS: Because of several methodology flaws in the reviewed studies, these results suggest that there is currently no research evidence to suggest that the use of ORC+C improves wound healing rates of DFUs. Additional research with high-quality RCTs focused on diabetic ulcers is necessary.

At Guarulhos University in São Paulo, Brazil, Gisele Chicone, MS, RN, CWOCN, is a Master’s Student, Nursing Postgraduate Program; Viviane Fernandes de Carvalho, PhD, RN, is Assistant Professor, Nursing Postgraduate Program; and André Oliveira Paggiaro, PhD, MD, is Assistant Professor, Nursing Postgraduate Program. The authors have disclosed no financial relationships related to this article. Submitted May 20, 2016; accepted in revised form September 7, 2016.

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