{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T14:18:23Z","timestamp":1790864303670,"version":"4.1.0"},"reference-count":33,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2016,6,3]],"date-time":"2016-06-03T00:00:00Z","timestamp":1464912000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Wound Repair Regeneration"],"published-print":{"date-parts":[[2016,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Skin substitutes are increasingly used in the treatment of various types of acute and chronic wounds. The aim of this study was to perform a systematic review and meta\u2010analysis to evaluate the effectiveness of skin substitutes on ulcer healing and limb salvage in the treatment of diabetic foot ulcers. Randomized clinical trials were searched and assessed following the methodology of The Cochrane Collaboration. We included 17 trials, totaling 1655 randomized participants. Risk of bias was variable among included trials. Thirteen trials compared the skin substitutes with standard care. The pooled results showed that that skin substitutes can, in addition to standard care, increase the likelihood of achieving complete ulcer closure compared with standard care alone after 6\u201316 weeks (risk ratio 1.55, 95% confidence interval [CI] 1.30\u20131.85). Four of the included trials compared two types of skin substitutes but no particular product showed a superior effect over another. Two trials reported on total incidence of lower limb amputations. Pooling the results of these two trials yielded a statistically significantly lower amputation rate among patients treated with skin substitutes (risk ratio 0.43, 95% CI 0.23\u20130.81), although the absolute risk difference was small (\u22120.06, 95% CI \u22120.10 to \u22120.01). This systematic review provides evidence that skin substitutes can, in addition to standard care, increase the likelihood of achieving complete ulcer closure compared with standard care alone in the treatment of diabetic foot ulcers. However, effectiveness on the long term, including lower limb salvage and recurrence, is currently lacking and cost\u2010effectiveness is unclear.<\/jats:p>","DOI":"10.1111\/wrr.12434","type":"journal-article","created":{"date-parts":[[2016,4,10]],"date-time":"2016-04-10T11:55:39Z","timestamp":1460289339000},"page":"737-744","source":"Crossref","is-referenced-by-count":50,"title":["Systematic review and meta\u2010analysis of skin substitutes in the treatment of diabetic foot ulcers: Highlights of a Cochrane systematic review"],"prefix":"10.1111","volume":"24","author":[{"given":"T. B. Katrien","family":"Santema","sequence":"first","affiliation":[{"name":"Department of Surgery Academic Medical Center Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul P. C.","family":"Poyck","sequence":"additional","affiliation":[{"name":"Department of Vascular and Transplant Surgery Radboudumc Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dirk T.","family":"Ubbink","sequence":"additional","affiliation":[{"name":"Department of Surgery Academic Medical Center Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,6,3]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.22.3.382"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11892-003-0010-4"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(03)13169-8"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.848"},{"key":"e_1_2_6_6_1","doi-asserted-by":"crossref","first-page":"S6","DOI":"10.1002\/dme.1996.13.s1.6","article-title":"The epidemiology of diabetic foot 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