DOI: https://doi.org/10.14710/nmjn.v15i2.67063

Network Meta-Analysis of Wound Dressings and Their Effectiveness in Promoting Healing

*Asmat Burhan orcid scopus publons  -  School of Nursing, Faculty of Health, Universitas Harapan Bangsa, Indonesia
Indah Susanti orcid  -  School of Nursing, Faculty of Health, Universitas Harapan Bangsa, Indonesia
Vanessa A Breu Da Silva orcid scopus  -  Universidade Estadual de Campinas, Brazil
Vijay Kumar orcid scopus  -  All India Institute of Medical Sciences, India
Do Thi Kim Chi orcid  -  Bach Mai Medical Colledge, Bach Mai Hospital, Viet Nam
Riski Hidayat orcid  -  School of Nursing, Faculty of Health, Universitas Nasional, Indonesia
Septian Mixrova Sebayang orcid scopus  -  School of Nursing, Faculty of Health, University of Harapan Bangsa, Indonesia
Hamka Hamka orcid  -  Nursing Science Study Program, Faculty of Medicine and Health Sciences, Universitas Lambung Mangkurat, Indonesia
Open Access Copyright (c) 2025 by the Authors, Published by Department of Nursing, Faculty of Medicine, Universitas Diponegoro
Creative Commons License This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

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Abstract

Background: Chronic and acute wounds affect millions of individuals worldwide, placing a substantial burden on patients and healthcare systems. Previous evaluations have often focused on limited types of dressings or specific wound conditions. Therefore, a comprehensive network meta-analysis is essential for comparing various interventions, bridging knowledge gaps, improving healing outcomes, and addressing clinical and economic challenges.

Purpose: This study assessed the comparative effectiveness and safety of advanced wound dressings in promoting healing.

Methods: This network meta-analysis, registered with PROSPERO (CRD42023433268), systematically searched PubMed, ProQuest, Scopus, CINAHL, ScienceDirect, Springer Nature, Wiley, Cochrane Library, and Taylor & Francis from January 2012 to December 2022. Eight reviewers independently assessed and extracted data from randomized controlled trials evaluating different dressings, including placebo, alginate, collagen, gamat, honey, hyaluronic acid, hydrocolloid, hydrogel, mebo, platelet-rich plasma, povidone-iodine, and silver sulfadiazine. Data were synthesized using a random-effects network meta-analysis with SUCRA rankings. Study quality was evaluated using Cochrane RoB2, and certainty of evidence was assessed through CINeMA.

Results: This review included 38 RCTs with a total of 4,049 patients. The largest placebo group comprised 1,628 participants, while the smallest group was mebo with 10 participants. Heterogeneity and consistency analysis showed negligible variation (χ² = 1.757, p = 0.78). Alginate dressings were the most effective in reducing wound size compared to placebo (OR 0.64; 95% CI 0.38–1.08; SUCRA probability 0.73), whereas hyaluronic acid dressings were the least effective (OR 0.22; 95% CI 0.06–0.79; SUCRA probability 0.08).

Conclusion: Alginate was identified as the most effective primary dressing for wound healing, while hyaluronic acid dressings were the least effective. However, clinical practitioners should carefully weigh the benefits and limitations of each dressing type before selecting the most appropriate treatment for patients.

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Keywords: Dressings; network meta-analysis; wound; wound care; wound healing
Funding: None

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