Summary of findings 9. Hyaluronic acid compared with dextranomer for leg ulcers.
| Hyaluronic acid compared with dextranomer for leg ulcers | ||||||
| Patient or population: people with leg ulcers Setting: hospitalised patients Intervention: hyaluronic acid Comparison: dextranomer | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | № of participants (studies) | Certainty of the evidence (GRADE) | Comments | |
| Risk with dextranomer | Risk with hyaluronic acid | |||||
| Complete ulcer healing ‐ not reported | No studies provided evidence for this outcome. | |||||
| Time to complete wound healing ‐ not reported | No studies provided evidence for this outcome. | |||||
| Adverse events | "There were five reports of side‐effects (local pain, a local burning sensation, panniculitis and a prickling sensation) in the HA group and two reports in the dextranomer group (surrounding eczema and local pain)." 1 participant (hyaluronic acid group) dropped out due to the onset of pain and a burning sensation. We were not able to estimate the rate of specific adverse events between groups. | ‐ | 50 (1 RCT) | ⊕⊝⊝⊝ Very low 1 2 | It is uncertain if hyaluronic acid increases adverse events compared with dextranomer. | |
| 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 (21 days) | The mean change was 4.2. | The mean change was 10.0. | MD 5.80 higher (10 lower to 21.60 higher) | 50 (1 RCT) | ⊕⊝⊝⊝ Very low 1 2 | It is uncertain if hyaluronic acid promotes a greater change in ulcer size when compared with dextranomer. |
| *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; MD: mean difference; RCT: randomised controlled trial | ||||||
| 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 once for risk of bias due to unclear risk of bias for randomisation, allocation concealment, and blinding of participants and personnel and outcome assessment. 2Downgraded twice for imprecision due to small numbers of participants and wide confidence intervals.