Immune-Regulating Hydrogels Most Effective for Healing Diabetic Foot Ulcers, Study Finds
China: A recent meta-analysis encompassing 23 studies found that among different functional hydrogel dressings used for diabetic foot ulcers (DFUs), immune-regulating hydrogels (IRHs) demonstrated the highest effectiveness (estimated effect: 2.2). This was followed by multi-functional and proliferation-promoting hydrogels (1.7), while antibacterial hydrogels showed the least efficacy (1.3). The incidence of adverse events associated with functional hydrogel dressings was low across all types.
The findings were published online in Diabetes, Obesity and Metabolism on 08 April 2025.
Functional hydrogel dressings represent a promising therapeutic option for managing diabetic foot ulcers (DFUs), with their effectiveness largely dependent on the specific formulation used. Recognizing the need to optimize treatment outcomes, Xiao Long, Peking Union Medical College Hospital, Beijing, China, and colleagues systematically evaluated and compared the efficacy of various types of functional hydrogel dressings in promoting DFU healing.
For this purpose, the researchers conducted a systematic review and Bayesian network meta-analysis of randomized controlled trials assessing the effectiveness of functional hydrogel dressings in the treatment of diabetic foot ulcers. They performed a comprehensive literature search across databases, including PubMed, Embase, CENTRAL, CNKI, and Web of Science, from inception to June 2024. The analysis focused on comparing the relative efficacy of different hydrogel formulations, with complete wound closure as the primary outcome measure.
The following were the key findings:
- The analysis included 23 studies involving 1,671 patients with diabetic foot ulcers (DFUs).
- Immuno-regulating hydrogels (IRHs) demonstrated the highest efficacy with an effect estimate of 2.2.
- Anti-bacterial hydrogels (ABHs) showed the lowest effectiveness with an estimate of 1.3.
- Multi-functional hydrogels (MFHs) and proliferation-promoting hydrogels (PPHs) showed moderate efficacy, each with an estimate of 1.7.
- The overall ranking of relative efficacy was: IRH > MFH/PPH > ABH > placebo.
- Functional hydrogel dressings were associated with a lower risk of adverse events than placebo (risk estimate 0.75).
- Node-splitting analysis confirmed consistency between direct and indirect comparisons, particularly between IRH and ABH.
- Funnel plot analysis indicated no major publication bias, supporting the strength and reliability of the results.
The study offers a detailed comparison of various functional hydrogel dressings used in treating diabetic foot ulcers. Among the different types analyzed, immune-regulating hydrogels emerged as the most effective in promoting wound healing.
"These findings provide valuable guidance for doctors and researchers working to improve DFU care. By identifying the most promising dressing options, the study lays the foundation for better treatment strategies and future research aimed at enhancing patient outcomes," the authors concluded.
Reference: https://doi.org/10.1111/dom.16367
