Should ‘ one size fit all ? ’

Silver dressings were compared with non-antimicrobial, low-adherent control dressings. A total of 304 patients were recruited, all with venous ulceration of the lower leg that had been present for more than 6 weeks, of whom 213 participated in the trial, and 91 underwent observation only. Participants were randomized to receive either an antimicrobial silver dressing (n = 107) or a control dressing (n = 106). Both dressings were applied underneath compression bandages or hosiery. The choice of dressing type was made by the treating clinician; the silver dressing was selected from an approved list (Aquacel® Ag, ActicoatTM, ActicoatTM 7, ActicoatTM Absorbent, Contreet® Foam and Urgotul® SSD), the control dressing was specified as any nonantimicrobial dressing from any manufacturer. Clinical assessment by the treating clinician was used to evaluate dressing effectiveness, with a primary outcome measure of complete healing at 12 weeks. Costs and resource use, quality-adjusted life-years (QALYs), cost-effectiveness, time to healing, and recurrence rates at 6 months and 1 year were used as secondary outcome measures.