***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: In this article , we describe a r and omised trial in which two established primary dressings - Comfeel ( Coloplast , UK ) and Granuflex improved formulation ( Convatec , UK ) - were compared to Cutinova foam ( Beiersdorf Medical , UK ) in the management of  venous leg ulcers . Patients that met the study trial criteria were r and omised to receive one of the three primary dressings . All ulcers were secondarily b and aged with Comprilan  ( Beiersdorf Medical , UK ) short-stretch compression . The three dressings were compared in terms of their ability to promote ulcer healing ( closure rate and healing rate ) and reduce the prevalence and severity of ulcer-associated pain , over a 12-week period . The ease with which dressings could be used in a busy outpatient clinic setting was also considered . On enrollment , groups were well matched in terms of all of the patient and ulcer parameters studies . Six patients were withdrawn for reasons unrelated to study dressings or trial procedures . Following non-parametric analysis of the study data , the three dressings were found to be equally effective at promoting ulcer healing and alleviating ulcer-associated pain . Study personnel rated Cutinova Foam as easy , if not easier , to use than Comfeel or Granuflex . This study suggests that Cutinova Foam is as safe and effective as both Comfeel and Granuflex , in the treatment of venous leg ulcers : In recent years , skin grafting has evolved from the initial autograft and allograft preparations to biosynthetic and tissue-engineered living skin replacements . This review details the pioneering work of numerous investigators that led to the following precursors of tissue-engineered skin replacement : cultured autologous keratinocyte grafts , cultured allogeneic keratinocyte grafts , autologous/allogeneic composites , acellular collagen matrices , and cellular matrices . It also discusses the rationale for the development of the newer products and describes the technical advances leading to the development of Apligraf , a tissue-engineered human skin product Background Pressure sores are important and common complications of spinal cord injury . Many preventive and therapeutic approaches have been tried and new trials are evolving . One relatively recent method is application of a hydrocolloid dressing ( HD ) . In this study we compared the therapeutic effects of HD on pressure ulcer healing with two other topical applications , phenytoin cream ( PC ) and simple dressing ( SD ) . Methods Ninety-one stage I and stage II pressure ulcers of 83 paraplegic male victims of the Iran-Iraq war were r and omly allocated to three treatment groups . Mean age and weight of the participants were 36.64 ± 6.04 years and 61.12 ± 5.08 kg , respectively . All the patients were managed in long term care units or in their homes for 8 weeks by a team of general practitioners and nurses , and the ulcer status was recorded as " Complete healing " , " Partial healing " , " Without improvement " and " Worsening " . Results Complete healing of ulcers , regardless of location and stage , was better in the HD group than the PC [ 23/31(74.19 % ) vs 12/30(40 % ) ; difference : 34.19 % , 95 % CI = 10.85–57.52 , ( P < 0.01 ) ] or the SD [ 23/31(74.19 % ) vs 8/30(26.66 % ) ; difference : 47.53 % , 95 % CI = 25.45–69.61 , ( P < 0.005 ) ] groups . Complete healing of stage I ulcers in the HD group [ 11/13(85 % ) ] was better than in the SD [ 5/11(45 % ) ; difference : 40 % , 95 % CI = 4.7–75.22 , ( P < 0.05 ) ] or PC [ 2/9 ( 22 % ) ; difference : 63 % , 95 % CI = 29.69–96.3 , ( P < 0.005 ) ] groups . Complete healing of stage II ulcer in the HD group [ 12/18 ( 67 % ) ] was better than in the SD group [ 3/19(16 % ) ; difference : 51 % , 95 % CI = 23.73–78.26 , ( P < 0.005 ) ] , but not significantly different from the PC group [ 10/21 ( 48 % ) ; difference : 19 % , 95 % CI = -11.47–49.47 , ( P > 0.05 ) ] . We performed a second analysis considering only one ulcer per patient ( i.e. 83 ulcers in 83 patients ) . This " per patient " analysis showed that complete ulcer healing in the HD group was better than in the PC [ 20/28(71.4 % ) vs 11/28 ( 39.3 % ) ; difference : 32.1 % , 95 % CI = 7.4–56.7 , ( P < 0.01 ) ] or SD [ 20/28(71.4 % ) vs 8/27 ( 29.6 % ) ; difference : 41.8 % , 95 % CI = 17.7–65.8 , ( P < 0.005 ) ] groups . Conclusion We deduced that HD is the most effective method investigated for treating stage I and II pressure ulcers in young paraplegic men OBJECTIVES To determine the comparative effectiveness and cost-effectiveness of three dressing products , N-A , Inadine and Aquacel , for patients with diabetic foot ulcers , as well as the feasibility and consequences of less frequent dressing changes by health-care professionals . DESIGN A multicentre , prospect i ve , observer-blinded , parallel group , r and omised controlled trial , with three arms . SETTING Established expert multidisciplinary clinics for the management of diabetic foot ulcers across the UK . PARTICIPANTS Patients over age 18 with type 1 or type 2 diabetes with a chronic ( present for at least 6 weeks ) full-thickness foot ulcer ( on or below the malleoli ) not penetrating to tendon , periosteum or bone , and with a cross-sectional area between 25 and 2500 mm(2 ) . INTERVENTIONS Participants were r and omised 1:1:1 to treatment with one of N-A ( a non-adherent , knitted , viscose filament gauze ) , Inadine ( an iodine-impregnated dressing ) , both traditional dressings , or Aquacel , a newer product . MAIN OUTCOME MEASURES The primary outcome measure was the number of ulcers healed in each group at week 24 . Secondary measures included time to healing , new ulcerations , major and minor amputations , and episodes of secondary infection . RESULTS A total of 317 patients were r and omised . After 88 withdrawals , 229 remained evaluable . A greater proportion of smaller ( 25 - 100 mm(2 ) ulcers healed within the specified time ( 48.3 % versus 37.3 % ; p = 0.048 ) . There was , however , no difference between the three dressings in terms of percentage healed by 24 weeks , or in the mean time to healing , whether analysed on the basis of intention to treat ( Inadine 44.4 % , N-A 38.7 % , Aquacel 44.7 % ; not significant ) or per protocol ( Inadine 55.2 % , N-A 59.4 % , Aquacel 63.0 % ; not significant ) . There was no difference in the quality of healing , as reflected in the incidence of recurrence within 12 weeks . Likewise , there was no difference in the incidence of adverse events , although a greater proportion of those r and omised to the non-adherent dressings were withdrawn from the study ( 34.9 % versus 29.1 % Aquacel and 19.4 % Inadine ; p = 0.038 ) . The only statistically significant difference found in the health economic analysis was the cost associated with the provision of dressings ( mean cost per patient : N-A 14.85 pounds , Inadine 17.48 pounds , Aquacel 43.60 pounds ) . The higher cost of Aquacel was not offset by the fewer dressings required . There was no difference in measures of either generic or condition-specific measures of quality of life . However , there was a significant difference in the change in pain associated with dressing changes between the first and second visits , with least pain reported by those receiving non-adherent dressings ( p = 0.012 ) . There was no difference in the costs of professional time , and this may relate to the number of dressing changes undertaken by non-professionals . Fifty-one per cent of all participants had at least one dressing change undertaken by themselves or a non-professional carer , although this ranged from 22 % to 82 % between the different centres . CONCLUSIONS As there was no difference in effectiveness , there is no reason why the least costly of the three dressings could not be used more widely across the UK National Health Service , thus generating potentially substantial savings . The option of involving patients and non-professional carers in changing dressings needs to be assessed more formally and could be associated with further significant reductions in health-care costs . TRIAL REGISTRATION Current Controlled Trials IS RCT N78366977 OBJECTIVE To evaluate the utility of a semipermeable polymeric membrane dressing for the treatment of  chronic diabetic foot ulcers .  RESEARCH DESIGN AND METHODS Nineteen subjects with either insulin- dependent diabetes mellitus ( IDDM ) or non-insulin-dependent diabetes mellitus ( NIDDM ) and foot ulcers were r and omly assigned to the polymeric dressing or conventional wet-to-dry saline dressings . Subjects had foot ulcer site measurements performed every 3 weeks . The subjects using conventional therapy were allowed to cross over to polymeric dressing after 2 months . RESULTS At the end of 2 months , in the patients using the polymeric dressing , ulcer size was reduced to 35 ± 16 % of baseline . The patients on conventional therapy had an ulcer size of 105 ± 28 % of baseline ( P < 0.03 , polymeric vs. conventional ) . Patients initially treated with wet-to-dry saline were crossed over into the polymeric membrane treatment and demonstrated a decrease to 35 ± 11 % of baseline size ( P < 0.02 ) after an additional 2 months . CONCLUSIONS The semipermeable polymeric membrane dressing is a useful therapeutic option for treating uncomplicated chronic diabetic foot ulcers A hydropolymer dressing ( Tielle ) and a hydrocolloid dressing ( Granuflex ) were compared in a r and omised controlled clinical study involving 100 patients with leg ulcers and 99 patients with pressure sores in the community . Statistically significant differences in favour of the hydropolymer dressing were detected for dressing leakage and odour production , but no statistically significant differences were recorded in the number of patients with either leg ulcers or pressure sores who healed in each treatment group In a multicentre , prospect i ve , r and omised trial of 44 patients with exuding leg ulcers , a new hydrofibre dressing was compared with an alginate dressing in terms of dressing performance , patient comfort , safety and cost-effectiveness . The groups were well matched with regard to sex and age . A statistically significant difference between treatment groups was observed in mean wear time , with a longer wear time of four days observed in the hydrofibre dressing group compared to three days in the alginate group . The hydrofibre dressing group therefore demonstrated a significantly lower frequency of dressing changes required per week . Significantly more patients achieved a seven-day wear time with the hydrofibre dressing than with the alginate dressing . There was no difference with regard to percentage change in ulcer area . Cost-effectiveness was based on the cost of dressings , compression therapy and nursing time to achieve a healed wound . However , because of small patient numbers , it was difficult to make an accurate comparison . This study suggests that the hydrofibre dressing may have clinical benefits that merit further investigation with larger patient numbers Venous leg ulcers are the most prevalent form of chronic wounds in the Western world . The principles of moist wound healing coupled with the use of graduated compression b and aging have become the cornerstone of treatment for venous leg ulcers but not all moist dressings are alike . To compare the attributes of a foam composite dressing with those of a hydrocellular foam dressing in the management of venous leg ulcers , a prospect i ve , r and omized , comparative 12-week study was conducted in 15 centers in the US , Canada , France , Germany , and the UK . Dressings were changed and compression b and ages applied per manufacturer recommendations and dressing performance was assessed at every dressing change and at the final evaluation . Patients with venous ulcers were r and omized to treatment for 12 weeks with either hydrocellular foam ( n = 52 ) or foam composite ( n = 55 ) dressing .  Healing differences between the groups were not statistically significant , with 36 % of patients using foam composite dressing healed in a mean of 66 days and 39 % of patients using hydrocellular foam dressing healed in a mean of 73 days . However , the foam composite dressing performed significantly better than the hydrocellular foam dressing with regard to condition of the periwound skin - 55 % of patients in the foam composite group having healed or markedly improved surrounding skin compared to 37 % of patients using hydrocellular foam ( P = 0.03 ) . The foam composite dressing was rated significantly better than the hydrocellular foam dressing ( " very good " to " excellent " ) in level of satisfaction with conformability ( 87 % 
    Output:
    
The other dressing comparisons showed no statistically significant differences between the interventions examined in terms of achieving complete diabetic foot ulcer healing .
Non-adherent dressings were more cost-effective than hydrofiber dressings for diabetic foot ulcers in terms of mean total cost per patient of the dressings themselves .
All venous leg ulcer pairwise dressing comparisons showed equivalent dressing efficacies in terms of promoting complete ulcer healing .
Overall , most synthetic active dressings and traditional wound dressings are equally efficacious in treating diabetic foot ulcers and venous leg ulcers .
For treating diabetic foot ulcers , hydrogels are more efficacious than basic wound contact dressings , and non-adherent dressings are more cost-effective than hydrofiber dressings .