당뇨병성 족부 궤양에서 은 함유 드레싱의 유효성: 체계적 고찰 및 메타 분석

초록

Diabetic foot ulcers (DFUs) represent a major complication of diabetes, frequently culminating in infection, limb amputation, and in creased healthcare burden. Silver-based dressings have been used in chronic wound care because of their broad-spectrum antimicrobial and anti-inflammatory properties. Despite their widespread use, the clinical efficacy of silver dressings in DFU management remains inconclusive, and their use in diabetic foot care has not been available in Korea. A systematic review and meta-analysis were conducted to evaluate the effectiveness of silver-based dressings for the treatment of DFUs. Randomized controlled trials comparing silver dressings with standard or non-silver dressings were identified through a comprehensive search of PubMed, Embase, and the Cochrane Library, following the PRISMA guidelines. The primary outcome was the complete healing rate; secondary outcomes included ulcer size reduc tion, time to healing, infection control, and adverse events. Meta-analysis revealed a significantly higher complete healing rate in the silver dressing group compared to controls (risk ratio=1.28; 95% CI, 1.03–1.60; p=0.03). Although the trends toward improved ulcer area reduction and shorter healing duration were observed, statistical significance was not uniformly achieved. Owing to insufficient data, the infection control outcomes were synthesized narratively, revealing potential clinical benefits. No severe adverse events were reported across studies. Silver-based dressings may confer therapeutic benefit in the management of DFUs, particularly in high-risk or infected wounds. These findings provide important evidence to inform the clinical guidelines and reimbursement decisions regarding the use of silver dressings in diabetic foot care in Korea. This meta-analysis has limitations because of factors such as the heterogeneity across stud ies and the small number of included studies. Therefore, further research is needed in the future.

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