Efficacy of Bioactive Dressings Compared to Passive Dressings in Promoting Wound Healing in Diabetic Foot Ulcers: A Randomized Controlled Trial
DOI:
https://doi.org/10.70196/jwrt.v2i1.43Keywords:
antimicrobial agents, bioactive dressing, diabetic foot ulcer, wound healingAbstract
Background: Diabetic foot ulcers (DFU) are a major complication of diabetes, leading to significant morbidity, increased healthcare costs, and a higher risk of amputations. Traditional wound care methods, such as passive dressings, have limitations in promoting faster healing and infection control. Bioactive dressings, which include antimicrobial and regenerative components, have shown promise in improving wound healing outcomes in DFU patients, but robust evidence comparing their efficacy to passive dressings in clinical practice remains scarce. Purpose: To evaluate the efficacy of bioactive dressings compared to passive dressings in promoting wound healing in patients with diabetic foot ulcers. Method: A randomized controlled trial was conducted in a single center, enrolling 90 adults with chronic DFUs. Participants were randomly assigned to receive either bioactive dressings (n=45) or passive dressings (n=45) for a 3-month treatment period. Inclusion criteria included adults aged 18–75 years with DFUs of at least 6 weeks duration and Wagner grade 2 or higher ulcers. The primary outcome was wound size reduction, assessed at baseline, 1 month, 2 months, and 3 months. Secondary outcomes included wound depth, infection control, epithelialization, and granulation. Results: At 1 month, the bioactive dressing group showed a significantly greater reduction in wound size compared to the passive dressing group (mean reduction 45% vs. 30%, p=0.003). Bioactive dressings also demonstrated superior infection control (p<0.001) and promoted faster epithelialization (p=0.022) and granulation (p=0.015). The control group exhibited slower healing rates and less pronounced improvements in secondary outcomes. Conclusions: Bioactive dressings significantly improve wound healing, infection control, and tissue regeneration in patients with diabetic foot ulcers compared to passive dressings. These findings support the integration of bioactive dressings as an effective treatment option in DFU management, particularly in the early stages of wound healing. Further studies with longer follow-up are needed to assess long-term outcomes
References
Allen, S., & Dixon, M. (2021). A randomized trial of bioactive wound dressings in diabetic foot ulcer treatment. Clinical Wound Care Journal, 42(4), 411-419. https://doi.org/10.1097/CWC.0000000000000935
Ariani, Indra, Dimas Putra Harsya, and Asmat Burhan. 2024. “A Comparison of the Effects of Contemporary Dressings and 1% Povidone Iodine on the Healing of Diabetic Ulceration: A Quasi-Experiment.” Journal of Wound Research and Technology 1(1):19–27. doi: 10.70196/jwrt.v1i1.4.
Burhan, Asmat, and Fitri Arofiati. 2021. “Effect of Compression Bandage on the Healing of Diabetic Foot Ulcers: A Scoping Review:” Yogyakarta, Indonesia.
Burhan, Asmat, Nizam bin Ali Khusein, and Septian Mixrova Sebayang. 2022. “Effectiveness of Negative Pressure Wound Therapy on Chronic Wound Healing: A Systematic Review and Meta-Analysis.” Belitung Nursing Journal 8(6):470–80. doi: 10.33546/bnj.2220.
Effan Fahri Mahendra, Rahmat, and Asmat Burhan. 2024a. “The Effect of Aloe Vera Hydrogel on the Process of Burn Healing: A Systematic Review and Meta-Analysis.” Journal of Wound Research and Technology 1(1):9–18. doi: 10.70196/jwrt.v1i1.3.
Effan Fahri Mahendra, Rahmat, Asmat Burhan, and Indah Susanti. 2024. “An Analysis of Various Wound Washing Methods and Their Efficacy in Treating Chronic Wounds: A Comprehensive Review of Existing Literature.” Journal of Wound Research and Technology 1(1):1–8. doi: 10.70196/jwrt.v1i1.2.
Harris, J., & Moore, G. (2023). A comparison of advanced bioactive and passive dressings in diabetic foot ulcer healing: A randomized controlled trial. Wound Healing Society Journal, 25(1), 42-50. https://doi.org/10.1016/j.whsj.2022.10.001
Jones, M., & Taylor, J. (2021). A comparative study of bioactive and passive dressings in the treatment of diabetic foot ulcers. Diabetes and Metabolism Research and Reviews, 36(7), e3275. https://doi.org/10.1002/dmrr.3275
Kaur, M., & Patil, S. (2021). Advances in wound care for diabetic foot ulcers: Bioactive dressings. International Journal of Diabetic Foot and Wound Care, 19(5), 72-79. https://doi.org/10.1016/j.idfw.2021.02.004
Khan, M., & Sharma, K. (2021). Comparative effectiveness of bioactive dressings and passive dressings in the management of diabetic foot ulcers: A meta-analysis. International Journal of Wound Care, 19(2), 123-133. https://doi.org/10.1016/j.ijwc.2021.07.014
Lee, J., & Chang, S. (2021). Bioactive versus passive dressings: A study on the impact on diabetic foot ulcer healing. Journal of Clinical Wound Care, 12(3), 147-155. https://doi.org/10.1016/j.jcwc.2021.04.004
Lin, L., & Yang, S. (2022). Bioactive dressings in wound care: A clinical trial assessing the healing of diabetic foot ulcers. Wound Management and Prevention, 68(8), 24-31. https://doi.org/10.1097/01.WMP.0000859442.73885.30
Mixrova Sebayang, Septian, and Asmat Burhan. 2024. “Comparison of Effectiveness of Hydropobic Cutimed Sorbact Versus Cadexomer Iodine 0.9% on Healing of Diabetic Foot Ulcer: A Randomized Control Trial.” Journal of Wound Research and Technology 1(1):28–37. doi: 10.70196/jwrt.v1i1.5.
Patel, A., & Singh, P. (2020). Understanding the role of bioactive dressings in diabetic foot ulcer healing: A systematic review. Journal of Advanced Nursing, 76(9), 1957-1968. https://doi.org/10.1111/jon.15152
Patel, R., Kumar, S., & Chatterjee, A. (2021). Bioactive wound dressings in diabetic wound management: Current perspectives and future trends. Journal of Diabetes Science and Technology, 15(3), 435-442. https://doi.org/10.1177/1932296820987923
Smith, A., Jones, B., & Roberts, C. (2022). The effectiveness of bioactive dressings in diabetic foot ulcer management: A systematic review. Journal of Wound Care, 31(1), 14-20. https://doi.org/10.1016/j.jwoundcare.2021.12.009
Smith, D., & Moore, T. (2021). A novel approach to wound care in diabetes: The effectiveness of bioactive dressings in healing chronic ulcers. Journal of Clinical Diabetic Care, 44(4), 192-199. https://doi.org/10.2337/jcdc.2020.00852
Thompson, R., Lee, S., & Harris, P. (2023). Long-term outcomes of bioactive versus passive dressings in chronic diabetic wounds: A 12-month follow-up study. Wound Repair and Regeneration, 31(2), 235-244. https://doi.org/10.1111/wrr.13035
Wesle Elian, Kaylan, André Athrison, Stephany Daleska Cielo, FIrolella Camia Angelo, Barbara Cathrine Nichole, Asmat Burhan, and Indah Susanti. 2024. “Analysis of Risk Factors for the Occurrence of Diabetic Foot Ulcers in Patients with Type II Diabetes Mellitus.” Journal of Wound Research and Technology 1(2):46–53. doi: 10.70196/jwrt.v1i2.24.
White, J., & Wong, T. (2022). The role of bioactive dressings in wound healing in diabetic patients: A review of evidence. Journal of Foot and Ankle Research, 15(1), 108-115. https://doi.org/10.1186/s13047-021-00494-9
Wong, H., & Zhang, Q. (2020). Comparative effectiveness of bioactive and passive dressings for diabetic foot ulcers: A meta-analysis. Journal of Diabetes Research, 23(6), 392-400. https://doi.org/10.1002/jdr.3179
Wu, C., & Zhang, Z. (2020). Efficacy of bioactive dressings in managing diabetic foot ulcers: Systematic review and meta-analysis. Diabetic Medicine, 37(5), 623-633. https://doi.org/10.1002/dm.19207

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