Summary of findings 7. Hyaluronic acid compared with paraffin gauze for leg ulcers.
| Hyaluronic acid compared with paraffin gauze for leg ulcers | ||||||
| Patient or population: leg ulcers Setting: not reported Intervention: hyaluronic acid Comparison: paraffin gauze | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | № of participants (studies) | Certainty of the evidence (GRADE) | Comments | |
| Risk with paraffin gauze | Risk with hyaluronic acid | |||||
| Complete ulcer healing (56 days) | Study population | RR 2.00 (0.21 to 19.23) | 17 participants; 24 ulcers (1 RCT) | ⊕⊝⊝⊝ Very low 1 2 | It is uncertain if hyaluronic acid increases ulcer healing when compared with paraffin gauze. | |
| 83 per 1000 | 167 per 1000 (17 to 1000) | |||||
| Time to complete wound healing ‐ not reported | No studies provided evidence for this outcome. | |||||
| Adverse events ‐ not reported | No studies provided evidence for this outcome. | |||||
| Health‐related quality of life ‐ not reported | No studies provided evidence for this outcome. | |||||
| Pain | No studies provided evidence for this outcome. | |||||
| Change in ulcer size | Study authors reported mean improvement in ulcer healing at 8 weeks; however, they did not provide standard deviations, thereby precluding further analysis. | ‐ | ‐ | ⊕⊝⊝⊝ Very low 1 2 | It is uncertain if hyaluronic acid improves ulcer healing when compared with paraffin gauze. | |
| *The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; RCT: randomised controlled trial; RR: risk ratio | ||||||
| GRADE Working Group grades of evidence High certainty: we are very confident that the true effect lies close to that of the estimate of the effect. Moderate certainty: we are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low certainty: our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect. Very low certainty: we have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect. | ||||||
1Downgraded twice for risk of bias due to unclear risk of bias for randomisation and allocation and high risk of bias for blinding of participants and personnel and outcome assessment and other bias. 2Downgraded twice for imprecision due to small numbers of participants and events and wide confidence intervals.