Authors' objectives:

1. To determine the clinical effectiveness and cost-effectiveness of debriding agents in treating surgical wounds healing by secondary intention.

2. To evaluate the clinical effectiveness and cost-effectiveness of treating patients with surgical wounds healing by secondary intention at specialised wound care clinics as compared to conventional care.

Authors' results and conclusions: In summary, there is a suggestion that modern dressings have a beneficial effect on healing compared to traditional gauze dressings, especially for toenail avulsions, where significant benefits of modern dressings were found. However, these results should be interpreted with caution due to the poor quality of the studies, the fact that the direction of bias is unclear and the unknown effects of potential publication bias. There is some evidence to suggest a beneficial effect of modern dressings for surgical wounds on other outcomes, such as pain, dressing performance and resource use, although a beneficial effect for these outcomes was not found for studies of toenail avulsions. However, in addition to the methodological problems highlighted above, these outcome measures are very difficult to assess and are particularly subject to bias, especially in unblinded studies. In view of the lack of data and the poor methodological quality of the trials, there is no evidence to support the superiority of one type of modern dressing over another.

Authors' recommendations: The results of the cost-effectiveness data suggest partial dominance in favour of the intervention, and only the cost data support the use of the intervention dressings (modern dressings were found to have lower costs than the gauze dressings, but with no difference in the outcome measures). However, the quality of the clinical effectiveness and cost-effectiveness analyses are poor.

Authors' methods: Systematic review

Project Status: Completed

URL for project: http://www.hta.ac.uk/1196

Year Published: 2001

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: England, United Kingdom

Organisation Name: NIHR Health Technology Assessment programme

Contact Address: NIHR Journals Library, National Institute for Health and Care Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK

Contact Name: journals.library@nihr.ac.uk

Contact Email: journals.library@nihr.ac.uk

Copyright: 2009 Queen's Printer and Controller of HMSO