A Cochrane review included 6 studies involving a total of 375 participants. Alginate dressings were compared with basic wound contact dressings, foam dressings and a silver-containing, fibrous-hydrocolloid dressing. Meta analysis of two studies found no statistically significant difference between alginate dressings and basic wound contact dressings: risk ratio (RR) 1.09 (95% CI 0.66 to 1.80). Pooled data from two studies comparing alginate dressings with foam dressings found no statistically significant difference in ulcer healing (RR 0.67, 95% CI 0.41 to 1.08). There was no statistically significant difference in the number of diabetic foot ulcers healed when an anti-microbial (silver) hydrocolloid dressing was compared with a standard alginate dressing (RR 1.40, 95% CI 0.79 to 2.47; 1 trial). All studies had short follow-up times (six to 12 weeks), and small sample sizes.
A Cochrane review found no randomised trials or controlled clinical trials to evaluate the clinical effectiveness of dressings and topical agents containing silver for the treatment of diabetic foot ulcers, despite their widespread use. Trials are needed to determine clinical and cost-effectiveness and long term outcomes including adverse events.