In short Read article

Foam dressings for chronic complex wounds

Is their use evidence-based?

Chronic wounds associated with venous leg ulcers, bed sores and diabetes (diabetic ulcers of the feet) are very common. Their treatment is complex and intensive, and leads to high costs. Treatment guidelines for these problems recommend various (often expensive) wound dressings, produced by many different manufacturers, often without proven efficacy. The systematic review discussed here showed that there is currently no evidence for the efficacy of foam dressings. In practice, this means that choices are based merely on subjective arguments and arguments relating to the cost-effectiveness of applying foam dressings to treat chronic wounds. There is an urgent need for carefully designed research into the efficacy of the relatively expensive foam dressings, as well as of other wound treatments.

  • Guidelines offer care providers a choice of many different types of wound dressing for chronic wounds, without clear information on whether their efficacy has been proven.
  • No high-quality research is known in which the efficacy of foam dressings to treat venous leg ulcers, bed sores or diabetic ulcers of the feet is compared with that of other dressing materials.
  • The choice of using foam dressings for chronic wounds can only be based on subjective arguments, such as the personal preferences of the patients or care providers.
  • In view of the lack of evidence for their efficacy, cost considerations might provide an argument for avoiding the use of foam dressings and using traditional non-stick dressings instead.

  1. O'Meara S, Martyn-St James M. Foam dressings for venous leg ulcers. Cochrane Database Syst Rev. 2013(5):CD009907.
  2. Dumville JC, Deshpande S, O'Meara S, Speak K. Foam dressings for healing diabetic foot ulcers. Cochrane Database Syst Rev. 2013(6):CD009111.
  3. Walker RM, Gillespie BM, Thalib L, Higgins NS, Whitty JA. Foam dressings for treating pressure ulcers. Cochrane Database Syst Rev. 2017;10:CD011332.
  4. Nederlands Huisartsen Genootschap. NHG-Standaard Ulcus cruris venosum 2010 [Available from:
  5. de Jonge E. Antiseptische wondbedekkers bij complexe wonden. Gebu 2016;50(8):89-98.
  6. Slee PHTJ. Medische hulpmiddelen. Gebu 2013;47(6):63-69.
  7. VGZ. Vergoeding verbandmiddelen 2018 [Available from:
  8. Menzis. Verbandmiddelen 2018 [Available from:
  9. CZ. Vergoeding verbandmiddelen 2018 [Available from:
  10. Nederland Z. Aantal gebruikers 2012-2016, per hulpmiddelencategorie ( 2018 [Available from:
  11. Nederlandse Vereniging voor Dermatologie en Venereologie. Richtlijn Veneuze pathologie 2014 [Available from:
  12. Nederlands Huisartsen Genootschap. NHG-Standaard Decubitus 2015 [Available from:
  13. Overzicht wondbehandeling producten 2018 [Available from:
  14. Cochrane. Cochrane Methods Bias 2018 [Available from:
  15. Winter GD. Formation of the scab and the rate of epithelization of superficial wounds in the skin of the young domestic pig. Nature. 1962;193:293-4.
  16. Hinman CD, Maibach H. Effect of Air Exposure and Occlusion on Experimental Human Skin Wounds. Nature. 1963;200:377-8.
  17. Norman G, Westby MJ, Rithalia AD, Stubbs N, Soares MO, Dumville JC. Dressings and topical agents for treating venous leg ulcers. Cochrane Database Syst Rev. 2018;6:CD012583.

The literature refers to the Dutch text


  • mw S. van der Heijden MSc