Cochrane · systematic review · CD012235
Interventions for ulceration and other skin changes caused by nerve damage in leprosy
Reinar, LM, Forsetlund, L, Lehman, LF, et al. · Cochrane Database of Systematic Reviews · 2019 · Cochrane Library
SkinAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
100
current version
GRADE rated
40
No studies
59
Included studies
NR
No studies 59 · 59%Ungraded 1 · 1%Very low 39 · 39%Low 0 · 0%Moderate 1 · 1%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Zinc tape compared to magnesium sulphate glycerin for ulceration caused by nerve damage in leprosy
Population: ulceration caused by nerve damage in leprosy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Primary outcome: prevention of ulcers Zinc tape vs magnesium sulphate glycerin | no estimate extracted | NR | No studies |
Primary outcome: healing of ulcers (number of ulcers healed after 1 month) Zinc tape vs magnesium sulphate glycerin | RR 2 [0.43, 9.21] | 1 study · 28 participants | Very low Downgraded: risk of bias, imprecision |
Primary outcome: healing of ulcers (mean ulcer area (mm3) Zinc tape vs magnesium sulphate glycerin | no estimate extracted | 1 study · 28 participants | Very low Downgraded: risk of bias, imprecision |
Priimary outcome: adverse events Zinc tape vs magnesium sulphate glycerin | no estimate extracted | NR | No studies |
Secondary outcome: quality of life Zinc tape vs magnesium sulphate glycerin | no estimate extracted | NR | No studies |
Secondary outcome: acceptability of treatment Zinc tape vs magnesium sulphate glycerin | no estimate extracted | NR | No studies |
Secondary outcome: costs Zinc tape vs magnesium sulphate glycerin | no estimate extracted | NR | No studies |
Zinc tape compared to povidone iodine (10%) for ulceration and other skin changes caused by nerve damage in leprosy
Population: ulceration and other skin changes caused by nerve damage in leprosy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Primary outcome: prevention of ulcers Zinc tape vs povidone iodine (10%) | no estimate extracted | NR | No studies |
Primary outcome: healing of ulcers (mean reduction of ulcer area at 6 weeks (mm2)) Zinc tape vs povidone iodine (10%) | no estimate extracted | 1 study · 38 participants | Very low Downgraded: risk of bias, imprecision |
Primary outcome: adverse events Zinc tape vs povidone iodine (10%) | no estimate extracted | NR | No studies |
Secondary outcome: quality of life Zinc tape vs povidone iodine (10%) | no estimate extracted | NR | No studies |
Secondary outcome: acceptability of treatment Zinc tape vs povidone iodine (10%) | no estimate extracted | NR | No studies |
Secondary outcome: costs Zinc tape vs povidone iodine (10%) | no estimate extracted | NR | No studies |
Adhesive zinc tape compared to gauze soaked in eusol for ulceration caused by nerve damage in leprosy
Population: ulceration caused by nerve damage in leprosy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Primary outcome: prevention of ulcers Adhesive zinc tape vs gauze soaked | no estimate extracted | NR | No studies |
Primary outcome: healing of ulcer (days) Adhesive zinc tape vs gauze soaked | no estimate extracted | 1 study · 90 participants | Very low Downgraded: risk of bias, imprecision |
Primary outcome: adverse events (skin sensitisation at 2 months) Adhesive zinc tape vs gauze soaked | no estimate extracted | 1 study · 90 participants | Very low Downgraded: risk of bias, imprecision |
Secondary outcome: quality of life Adhesive zinc tape vs gauze soaked | no estimate extracted | NR | No studies |
Secondary outcome: acceptability of treatment Adhesive zinc tape vs gauze soaked | no estimate extracted | 1 study · 90 participants | Very low Downgraded: risk of bias, imprecision |
Secondary outcome: costs Adhesive zinc tape vs gauze soaked | no estimate extracted | NR | No studies |
Topical ketanserin (2%) compared to clioquinol cream (3%) or zinc paste for ulceration caused by nerve damage in leprosy
Population: ulceration caused by nerve damage in leprosy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Primary outcome: prevention of ulcers Topical ketanserin (2%) vs clioquinol cream (3%) or zinc paste | no estimate extracted | NR | No studies |
Primary outcome: healing of ulcers (healing of ulcer at 3 months) Topical ketanserin (2%) vs clioquinol cream (3%) or zinc paste | RR 6 [1.45, 24.75] | 1 study · 66 participants | Very low Downgraded: risk of bias, imprecision |
Primary outcome: adverse events (assessed at 3 months as minimum, moderate or severe) Topical ketanserin (2%) vs clioquinol cream (3%) or zinc paste | no estimate extracted | 1 study · 66 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Secondary outcome: quality of life Topical ketanserin (2%) vs clioquinol cream (3%) or zinc paste | no estimate extracted | NR | No studies |
Secondary outcome: acceptability of treatment Topical ketanserin (2%) vs clioquinol cream (3%) or zinc paste | no estimate extracted | NR | No studies |
Secondary outcome: cost of intervention Topical ketanserin (2%) vs clioquinol cream (3%) or zinc paste | no estimate extracted | NR | No studies |
Topical phenytoin compared to saline dressing for ulceration and other skin changes caused by nerve damage in leprosy
Population: ulceration and other skin changes caused by nerve damage in leprosy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Primary outcome: prevention of ulcers Topical phenytoin vs saline dressing | no estimate extracted | NR | No studies |
Primary outcome: healing of ulcers (mean percentage of ulcer volume reduction at 4 weeks (Bansal 1993)) Topical phenytoin vs saline dressing | no estimate extracted | 1 study · 100 participants | Very low Downgraded: risk of bias, imprecision |
Primary outcome: healing of ulcers (mean percentage reduction of ulcer size area at 4 weeks (Bhatia 2004)) Topical phenytoin vs saline dressing | no estimate extracted | 1 study · 23 participants | Very low Downgraded: risk of bias, imprecision |
Primary outcome: adverse events (up to 4 weeks) Topical phenytoin vs saline dressing | no estimate extracted | 2 studies · 123 participants | Very low Downgraded: risk of bias, imprecision |
Secondary outcome: quality of life Topical phenytoin vs saline dressing | no estimate extracted | NR | No studies |
Secondary outcome: acceptability of treatment Topical phenytoin vs saline dressing | no estimate extracted | NR | No studies |
Secondary outcome: cost of intervention Topical phenytoin vs saline dressing | no estimate extracted | NR | No studies |
Footwear ‐ canvas shoes compared to PVC boots for ulceration and other skin changes caused by nerve damage in leprosy
Population: ulceration and other skin changes caused by nerve damage in leprosy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Primary outcome: prevention of ulcer (number of persons developing new ulcers at 1 year) Footwear ‐ canvas shoes vs PVC boots | no estimate extracted | 1 study · 72 participants | Very low Downgraded: risk of bias, imprecision |
Primary outcome: healing of ulcer (number of persons being ulcer‐free at 1 year) Footwear ‐ canvas shoes vs PVC boots | RR 1.16 [0.77, 1.74] | 1 study · 38 participants | Very low Downgraded: risk of bias, imprecision |
Primary outcome: healing of ulcer (number of persons having ulcers not healed at 1 year) Footwear ‐ canvas shoes vs PVC boots | RR 0.52 [0.15, 1.75] | 1 study · 38 participants | Very low Downgraded: risk of bias, imprecision |
Primary outcome: adverse events Footwear ‐ canvas shoes vs PVC boots | no estimate extracted | 1 study · 38 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Secondary outcome: quality of life Footwear ‐ canvas shoes vs PVC boots | no estimate extracted | NR | No studies |
Secondary outcome: acceptability of treatment Footwear ‐ canvas shoes vs PVC boots | no estimate extracted | 1 study · 110 participants | Moderate Downgraded: risk of bias |
Secondary outcome: costs Footwear ‐ canvas shoes vs PVC boots | no estimate extracted | 1 study · 110 participants | Ungraded |
Padded moulded double‐rocker plaster shoe compared to padded below‐knee plaster for ulceration and other skin changes caused by nerve damage in leprosy
Population: ulceration and other skin changes caused by nerve damage in leprosy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Primary outcome: prevention of ulcer Padded moulded double‐rocker plaster shoe vs padded below‐knee plaster | no estimate extracted | NR | No studies |
Primary outcome: healing of ulcer (ulcers fully or nearly healed at 6 weeks) Padded moulded double‐rocker plaster shoe vs padded below‐knee plaster | RR 0.96 [0.77, 1.19] | 1 study · 55 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Primary outcome: adverse events Padded moulded double‐rocker plaster shoe vs padded below‐knee plaster | no estimate extracted | NR | No studies |
Secondary outcome: quality of life Padded moulded double‐rocker plaster shoe vs padded below‐knee plaster | no estimate extracted | NR | No studies |
Secondary outcome: acceptability of treatment Padded moulded double‐rocker plaster shoe vs padded below‐knee plaster | no estimate extracted | 1 study · 55 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Secondary outcome: costs of intervention Padded moulded double‐rocker plaster shoe vs padded below‐knee plaster | no estimate extracted | 1 study · 55 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Exposure to pulsed magnetic fields (in addition to self‐care and protective footwear) compared to self‐care and footwear for ulceration and other skin changes caused by nerve damage in leprosy
Population: ulceration and other skin changes caused by nerve damage in leprosy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Primary outcome: prevention of ulcer Exposure to pulsed magnetic fields (in addition to self‐care and protective footwear) vs self‐care and footwear | no estimate extracted | NR | No studies |
Primary outcome: healing of ulcer (at 4 to 5 weeks) Exposure to pulsed magnetic fields (in addition to self‐care and protective footwear) vs self‐care and footwear | no estimate extracted | 1 study · 33 participants | Very low Downgraded: risk of bias, imprecision |
Primary outcome 2 (healing of ulcer): Mean volume of ulcers at four to five weeks Exposure to pulsed magnetic fields (in addition to self‐care and protective footwear) vs self‐care and footwear | no estimate extracted | 1 study · 33 participants | Very low Downgraded: risk of bias, imprecision |
Primary outcome 3 (adverse events) Exposure to pulsed magnetic fields (in addition to self‐care and protective footwear) vs self‐care and footwear | no estimate extracted | NR | No studies |
Secondary outcome 1 (quality of life) Exposure to pulsed magnetic fields (in addition to self‐care and protective footwear) vs self‐care and footwear | no estimate extracted | NR | No studies |
Secondary outcome 2 (acceptability of treatment) Exposure to pulsed magnetic fields (in addition to self‐care and protective footwear) vs self‐care and footwear | no estimate extracted | NR | No studies |
Secondary outcome 3 (cost of intervention) Exposure to pulsed magnetic fields (in addition to self‐care and protective footwear) vs self‐care and footwear | no estimate extracted | 1 study · 33 participants | Very low Downgraded: risk of bias, imprecision |
Low‐level laser therapy compared to simple dressing for ulceration and other skin changes caused by nerve damage in leprosy
Population: ulceration and other skin changes caused by nerve damage in leprosy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Primary outcome: prevention of ulcer Low‐level laser therapy vs simple dressing | no estimate extracted | NR | No studies |
Primary outcome: healing of ulcer (size of ulcer (area) at 12 weeks (cm2)) Low‐level laser therapy vs simple dressing | no estimate extracted | 1 study · 23 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Primary outcome: healing of ulcer (size of ulcer (depth) at 12 weeks (mm)) Low‐level laser therapy vs simple dressing | no estimate extracted | 1 study · 23 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Primary outcome: adverse effects Low‐level laser therapy vs simple dressing | no estimate extracted | NR | No studies |
Secondary outcome: quality of life Low‐level laser therapy vs simple dressing | no estimate extracted | NR | No studies |
Secondary outcome: acceptability of treatment Low‐level laser therapy vs simple dressing | no estimate extracted | NR | No studies |
Secondary outcome: costs Low‐level laser therapy vs simple dressing | no estimate extracted | 1 study · 23 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Intralesional pentoxifylline compared to daily simple dressing for ulceration and other skin changes caused by nerve damage in leprosy
Population: ulceration and other skin changes caused by nerve damage in leprosy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Primary outcome: prevention of ulcer Intralesional pentoxifylline vs daily simple dressing | no estimate extracted | NR | No studies |
Primary outcome: healing of ulcer (complete healing of ulcer at 4 weeks) Intralesional pentoxifylline vs daily simple dressing | OR 9 [1.64, 49.45] | 1 study · 40 participants | Very low Downgraded: risk of bias, imprecision |
Primary outcome: healing of ulcer (ulcer depth (cm) at 4 weeks) Intralesional pentoxifylline vs daily simple dressing | no estimate extracted | 1 study · 40 participants | Very low Downgraded: risk of bias, imprecision |
Primary outcome: adverse events (at 4 weeks) Intralesional pentoxifylline vs daily simple dressing | no estimate extracted | 1 study · 40 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Secondary outcome: quality of life Intralesional pentoxifylline vs daily simple dressing | no estimate extracted | NR | No studies |
Secondary outcome: acceptability of treatment Intralesional pentoxifylline vs daily simple dressing | no estimate extracted | NR | No studies |
Secondary outcome: cost of intervention Intralesional pentoxifylline vs daily simple dressing | no estimate extracted | NR | No studies |
Light‐emitting diode (LED) irradiation compared to conventional dressing therapy for ulceration and other skin changes caused by nerve damage in leprosy
Population: ulceration and other skin changes caused by nerve damage in leprosy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Primary outcome: prevention of ulcer Light‐emitting diode (LED) irradiation vs conventional dressing therapy | no estimate extracted | NR | No studies |
Primary outcome: healing of ulcer (mean change of wound size (mm3) after 8 months treatment) Light‐emitting diode (LED) irradiation vs conventional dressing therapy | no estimate extracted | 1 study · 60 participants | Very low Downgraded: risk of bias, imprecision |
Primary outcome: adverse events Light‐emitting diode (LED) irradiation vs conventional dressing therapy | no estimate extracted | NR | No studies |
Secondary outcome: quality of life Light‐emitting diode (LED) irradiation vs conventional dressing therapy | no estimate extracted | NR | No studies |
Secondary outcome: acceptability of treatment Light‐emitting diode (LED) irradiation vs conventional dressing therapy | no estimate extracted | NR | No studies |
Secondary outcome: cost of intervention Light‐emitting diode (LED) irradiation vs conventional dressing therapy | no estimate extracted | NR | No studies |
Wax therapy compared to foot soaks for skin changes caused by nerve damage in leprosy
Population: skin changes caused by nerve damage in leprosy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Primary outcome: healing of ulcer Wax therapy vs foot soaks | no estimate extracted | NR | No studies |
Tertiary outcome: prevention and treatment of other skin changes (number of feet being fissure‐ and callous‐free at 6 weeks) Wax therapy vs foot soaks | RR 2.22 [1.07, 4.6] | 1 study · 44 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Primary outcome: prevention of ulcer Wax therapy vs foot soaks | no estimate extracted | NR | No studies |
Primary outcome: adverse effects Wax therapy vs foot soaks | no estimate extracted | NR | No studies |
Secondary outcome: quality of life Wax therapy vs foot soaks | no estimate extracted | NR | No studies |
Secondary outcome: acceptability of treatment (at 6 weeks) Wax therapy vs foot soaks | no estimate extracted | 1 study · 44 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Secondary outome: cost of intervention Wax therapy vs foot soaks | no estimate extracted | NR | No studies |
hAMMSC‐CM + vitamin C compared to hAMMSC‐CM for ulceration caused by nerve damage in leprosy
Population: ulceration caused by nerve damage in leprosy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Primary outcome: prevention of ulcer hAMMSC‐CM + vitamin C vs hAMMSC‐CM | no estimate extracted | NR | No studies |
Primary outcome: healing of ulcer (size, cm², at 8 weeks) hAMMSC‐CM + vitamin C vs hAMMSC‐CM | no estimate extracted | 1 study · 44 participants | Very low Downgraded: risk of bias, imprecision |
Primary outcome: healing of ulcer (depth, cm², at 8 weeks) hAMMSC‐CM + vitamin C vs hAMMSC‐CM | no estimate extracted | 1 study · 44 participants | Very low Downgraded: risk of bias, imprecision |
Primary outcome: adverse events hAMMSC‐CM + vitamin C vs hAMMSC‐CM | no estimate extracted | 1 study · 44 participants | Very low Downgraded: risk of bias, imprecision |
Secondary outcome: quality of life hAMMSC‐CM + vitamin C vs hAMMSC‐CM | no estimate extracted | NR | No studies |
Secondary outcome: acceptability of treatment hAMMSC‐CM + vitamin C vs hAMMSC‐CM | no estimate extracted | NR | No studies |
Secondary outome: cost of intervention hAMMSC‐CM + vitamin C vs hAMMSC‐CM | no estimate extracted | NR | No studies |
hAMMSC‐CM + vitamin E compared to hAMMSC‐CM for ulceration caused by nerve damage in leprosy
Population: ulceration caused by nerve damage in leprosy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Primary outcome: prevention of ulcer hAMMSC‐CM + vitamin E vs hAMMSC‐CM | no estimate extracted | NR | No studies |
Primary outcome: healing of ulcer (size, cm2 at 8 weeks) hAMMSC‐CM + vitamin E vs hAMMSC‐CM | no estimate extracted | 1 study · 44 participants | Very low Downgraded: risk of bias, imprecision |
Primary outcome: healing of ulcer (depth, cm2 at 8 weeks) hAMMSC‐CM + vitamin E vs hAMMSC‐CM | no estimate extracted | 1 study · 44 participants | Very low Downgraded: risk of bias, imprecision |
Primary outcome: adverse events hAMMSC‐CM + vitamin E vs hAMMSC‐CM | no estimate extracted | 1 study · 44 participants | Very low Downgraded: risk of bias, imprecision |
Secondary outcome: quality of life hAMMSC‐CM + vitamin E vs hAMMSC‐CM | no estimate extracted | NR | No studies |
Secondary outcome: acceptability of treatment hAMMSC‐CM + vitamin E vs hAMMSC‐CM | no estimate extracted | NR | No studies |
Secondary outome: cost of intervention hAMMSC‐CM + vitamin E vs hAMMSC‐CM | no estimate extracted | NR | No studies |
hAMMSC‐CM + vitamin E compared to hAMMSC‐CM + vitamin C for ulceration caused by nerve damage in leprosy
Population: ulceration caused by nerve damage in leprosy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Primary outcome: prevention of ulcer hAMMSC‐CM + vitamin E vs hAMMSC‐CM + vitamin C | no estimate extracted | NR | No studies |
Primary outcome: healing of ulcer (size, cm2, at 8 weeks) hAMMSC‐CM + vitamin E vs hAMMSC‐CM + vitamin C | no estimate extracted | 1 study · 44 participants | Very low Downgraded: risk of bias, imprecision |
Primary outcome: healing of ulcer (depth, cm2, at 8 weeks) hAMMSC‐CM + vitamin E vs hAMMSC‐CM + vitamin C | no estimate extracted | 1 study · 44 participants | Very low Downgraded: risk of bias, imprecision |
Primary outcome: adverse events hAMMSC‐CM + vitamin E vs hAMMSC‐CM + vitamin C | no estimate extracted | 1 study · 44 participants | Very low Downgraded: risk of bias, imprecision |
Secondary outcome: quality of life hAMMSC‐CM + vitamin E vs hAMMSC‐CM + vitamin C | no estimate extracted | NR | No studies |
Secondary outcome: acceptability of treatment hAMMSC‐CM + vitamin E vs hAMMSC‐CM + vitamin C | no estimate extracted | NR | No studies |
Secondary outome: cost of intervention hAMMSC‐CM + vitamin E vs hAMMSC‐CM + vitamin C | no estimate extracted | NR | No studies |