***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: Leg ulcers are a chronic manifestation of sickle-cell disease ( SCD ) and are often painful , disabling , and difficult to treat . RGD peptide matrix treatment is a novel therapy design ed to provide a topical synthetic extracellular matrix that can act as a temporary substitute for the damaged natural matrix at the ulcer site . In this r and omized , placebo-controlled , double-blind , prospect i ve , multicenter investigation , SCD patients with full-thickness leg ulcers were treated with st and ard therapy plus RGD peptide matrix or saline placebo once weekly for up to 10 weeks . Healing in patients with chronic ulcers ( 2 months or greater in duration ) was significantly accelerated ( P = .0085 ) in RGD peptide matrix recipients compared with the placebo group . In these chronic ulcer cases , the average percent ulcer closure ( decrease in ulcer surface area ) in the RGD peptide matrix group ( 54.4 % + /- 8.9 % ) exceeded that in the placebo group ( 19.0 % + /- 24.3 % ) nearly threefold by study endpoint . Furthermore , RGD peptide matrix was equally effective in promoting healing of long persistent ulcers and ulcers of shorter duration . In contrast , st and ard therapy plus placebo was significantly less effective ( P = .001 ) in promoting healing for ulcers of progressively greater duration . The results of this study provide preliminary evidence that RGD peptide matrix treatment may significantly accelerate healing of chronic sickle-cell leg ulcers A new dressing for chronic wounds  , BioFilm hydrogel dressing , was compared to a hydrocolloid dressing ( HCD ) control in a clinical trial involving 90 patients and 129 Stage I and II wounds ( defined by Enis and Sarmienti ) . The testing sites included both acute care and extended care facilities . A comparison of healing response and functional characteristics of both dressings was part of this assessment . Biofilm dressings demonstrated a healing advantage over the HCD . In addition , clinicians judged that the hydrogel dressings were easier to use and had superior fluid management capability and product integrity with minimal disruption to the healing wounds The author reports an open controlled trial on 72 patients affected by different types of skin ulcers , in which a heterologous lyophilized collagen sponge was compared with Dextranomer as healing adjuvant . The rationale of use and pharmacological properties of this collagen are outlined and explain its outst and ing results 1 . Topical irrigation with normal saline is known to produce rapid healing in chronic leg ulcers . This study was design ed to determine if the rate of healing could be improved by the addition of topical nutrition to the irrigating solution . 2 . Forty-eight patients with chronic leg ulcers were admitted to hospital for a minimum of 6 weeks bed-rest . During this time the ulcers were continuously irrigated by one of four test solutions . The solutions were : normal saline ; a dilute amino acid solution isotonic with the normal saline ; a hyperosmolar saline solution ; a hyperosmolar amino acid solution . There were 12 ulcers in each group . 3 . The amino acid solutions produced significantly faster healing than the saline solutions ( P less than 0.01 ) . Concentration had no significant effect on healing ( P greater than 0.15 ) . 4 . The application of amino acids does appear to enhance healing in this model of delayed wound healing . This effect does not depend only on the osmolarity of the solution used Applications of Condress ( patented sheets of pure bovine collagen ) on open skin surfaces ( 30 cases of " ulcus cruris " , 5 cases of decubitus , and malum perforans ; 10 cases of full-thickness burns ) were examined in a controlled trial . Quantification of regeneration speed , macrophotographic survey of granulation tissue and epithelial border , thermographic and chromometric evaluation of the skin microcirculation , and histological observation of regenerating tissues , were the parameters used . The following results were obtained : marked reduction of healing time , different aspects of the granulation-tissue responses , different times of topical collagenolysis , increased vascular perfusion , histological activation of angiogenesis , fibrogenesis , histiomacrophage function and superficial absorption . The employment of Condress in burn areas seems to be highly promising In a prospect i ve , r and omised , controlled trial of 92 patients with full-thickness pressure ulcers , the efficacy of an alginate wound dressing was compared to that of an established local treatment with dextranomer paste . During treatment , a minimal 40 % reduction in wound area was obtained in 74 % of the patients in the alginate group and in 42 % of those in the dextranomer group . The median time taken to achieve this goal was four weeks with alginate and more than eight weeks in the control group . Mean surface area reduction per week was 2.39cm2 ( sd 3.54 ) and 0.27cm2 ( sd 3.21 ) in the alginate and dextranomer groups respectively ( p=0.0001 ) . This difference was still highly significant when the sub-groups of almost completely healed subjects at the end of the study were considered . This striking healing efficacy of an alginate dressing suggests it possesses pharmacological properties which require further investigation Cultured epidermal allografts have been successfully used to treat a wide variety of skin defects ranging from burns to leg ulcers . Their postulated mechanism of action is through release of multiple cytokines that stimulate epithelialization from the wound periphery as well as from remnant epidermal appendages . A r and omized , controlled clinical trial was undertaken to compare the efficacy of cryopreserved cultured allograft dressings ( CCAD ) with tulle-gras dressings in the treatment of split-skin graft donor sites . Five patients were enrolled in the study and in each patient , half of the donor site was allografted and the other half was treated with tulle-gras control . The mean time to complete healing was 6.2 days for CCAD compared with 9.6 days ( p = 0.035 ) for the tulle-gras controls . Patient assessment of pain with dressing changes was also significantly lower at the CCAD-treated sites than at the control sites ( p = 0.001 ) . The results indicate that cultured allografts offer greater patient comfort and earlier maturation of regenerated skin The first r and omized , blinded , placebo-controlled  human trials of recombinant basic fibroblast growth factor ( bFGF ) for pressure sore treatment were performed . Three different concentrations of bFGF in five dosing schedules were tested for safety using hematology , serum chemistries , urinalysis , absorption , antibody formation , and signs of toxicity . Efficacy was evaluated by wound volumes , histology , and photography . No toxicity , significant serum absorption , or antibody formation occurred . In six of eight subgroups , there was a trend toward efficacy with bFGF treatment . When all subgroups were combined , comparison of the slopes of the regression curves of volume decrease over initial pressure sore volume demonstrated a greater healing effect for the  bFGF-treated patients ( p < 0.05 ) . Histologically , bFGF-treated wound sections demonstrated increased fibroblasts and capillaries .  More patients treated with bFGF  achieved > 70 % wound closure ( p < 0.05 ) . Blinded observers were able to distinguish differences in visual wound improvement between bFGF and placebo groups . These data suggest that bFGF may be effective in the treatment of chronic wounds A total of 67 patients with pressure ulcers were r and omized into one of three treatment modalities : hydrogel sheet dressing , hydrocolloid , or wet-to-moist gauze .  Safety , efficacy , and physical attributes of the three dressings were evaluated . No statistical significance was found in wound healing rate among the three treatments . Hydrogel sheets were advantageous in allowing wound visualization without dressing or wound disruption Interleukin-1beta is produced by numerous cell types including monocytes and fibroblasts . It has been shown to stimulate multiple cell types including fibroblasts , keratinocytes , endothelial cells , neutrophils , macrophages , and lymphocytes . Previously , interleukin-1beta was shown to accelerate healing in partial-thickness and full-thickness wounds in animals and was also shown to be safe when applied topically in Phase I human trials . Therefore a prospect ively r and omized , blind , placebo-controlled trial was performed with patients with chronic pressure ulcers . Doses of interleukin-1beta of .01 microg , .10 microg , and 1.0 microg per square centimeter did not show acceleration of healing of the pressure ulcers . Therefore use of recombinant human interleukin-1beta in this study was safe but , at the dose levels tested , did not result in improvement in the healing ratio OBJECTIVE To assess the effect of different dressings on  venous ulcer healing .  DESIGN A r and omised clinical trial . MATERIAL S Patients were r and omised to treatment with one of three dressings : a zinc oxide impregnated b and age , a zinc oxide impregnated stockingette , or an alginate dressing .  All patients were treated as out patients and had compression b and aging with two minimal stretch b and ages ( Elastocrepe ) and a stockingette ( Tubigrip ) to keep the b and ages in place . METHODS One hundred and thirteen patients ( 133 ulcerated limbs ) with chronic ulceration of the leg due to venous disease alone , and attending Fremantle Hospital Leg Ulcer Clinic , Western Australia were entered into the study . Healing was measured as complete healing of the ulcerated limb or failure of the limb to heal within 9 months . RESULTS There was no significant difference between the three groups in ulcer size , duration , and other parameters compared . Healing was affected significantly by ulcer size and which leg was ulcerated . There was significantly faster healing with the paste b and age . CONCLUSION The use of a paste b and age significantly improved the healing of chronic venous ulcers when used in combination with compression b and aging , and compared to an alginate dressing and a zinc oxide impregnated stockingette OBJECTIVE To determine the efficacy of the daily topical application of recombinant platelet-derived growth factor-BB ( rPDGF-BB ) , a recognized vulnerary agent , in the treatment of deep pressure ulcers . DESIGN Prospect i ve , r and omized , double-blind trial . SETTING Patients were treated in a nursing home or a hospital setting before transfer to a nursing home . PATIENTS Eligibility criteria included a clean pressure ulcer that had been adequately debrided and the absence of severe cardiac , pulmonary , or renal conditions . The causes of the ulcers were not related to a venous or arterial vascular disorder . The patients were elderly ( mean age , 68 to 74 years ) . INTERVENTIONS After r and omization , patients were given daily topical aqueous rPDGF-BB ( dosage , 100 or 300 micrograms/mL ) or placebo and saline gauze dressings were applied daily in addition to frequent turning . MAIN OUTCOME MEASURE Serial volume measurements of the healing wounds were taken using alginate molds . RESULTS The ulcers of 41 patients were analyzed . At the end of 28 days , median ulcer volumes had decreased to 83 % , 29 % , and 40 % of the initial size in the groups receiving placebo , rPDGF-BB , 100 micrograms/dL , and rPDGF-BB , 300 micrograms/mL , respectively . When adjusted for initial volume , ulcer volume after 28 days of treatment was smaller in the rPDGF-BB-treated groups compared with the placebo group ( analysis of covariance , P = .056 ) . Ulcers in the two rPDGF-BB-treated groups were significantly smaller in volume compared with those in the placebo group , using a linear contrast procedure . CONCLUSIONS Data from this small trial suggest that local application of rPDGF-BB may be of therapeutic benefit in accelerating the healing of chronic pressure ulcers We performed a r and omized , double‐blind study of the efficacy of locally applied zinc oxide on the healing of leg ulcers . Thirty‐seven geriatric patients , nineteen with arterial and eighteen with venous leg ulcers , were treated either with a gauze compress medicated with zinc oxide ( 400 μg ZnO/cm2 ) or with an identical compress without zinc oxide . The treatment was assessed from ulcer size measurements and the presence or abscncc of granulation and ulcer debridement over a period of 8 weeks . The zinc‐treated patients ( 83 % success rate ) responded significantly better ( P < 0·05 ) than the placebo‐treated patients ( 42 % success rate ) . The results suggest that healing of leg ulcers is improved after the addition of zinc oxide to the local regimen To determine the effect of bacterial colonization on venous ulcer healing , 82 patients with 100 venous ulcerated limbs were each studied prospect ively for six months . Despite bacteriological swab results , topical or systemic antibiotics were not administered unless cellulitis supervened . Initial ulcer size , length of ulcer history and time to complete healing of colonized and uncolonized ulcers were determined and compared OBJECTIVE To compare the clinical effectiveness and wound management properties of a copolymer membrane , Inerpan ( Synthélabo ) , and a hydrocolloid dressing , Comfeel ( Coloplast ) , in the treatment of decubitus ulcers in the elderly . DESIGN Open , r and omized , multicentric French study , with two parallel groups of patients . PATIENTS 168 in- patients aged more 65 years ( mean age : 82 years ) suffering from grade II to grade IV ( in the Shea classification ) pressure sores . TRIAL PERIOD : Either 8 weeks or 
    Output:
    
A meta- analysis of five reports comparing a hydrocolloid dressing with a traditional treatment suggested that treatment with the hydrocolloid result ed in a statistically significant improvement in the rate of pressure sore healing .
There was no difference in the proportion of ulcers healed between patients treated with cryopreserved cultured allografts or a hydrocolloid , though the former-treated ulcers had a higher rate of epithelialisation .
A  collagen dressing  was more effective than treatment with daily antiseptic .
However , publication bias was indicated in a comparison of traditional and hydrocolloid dressings .
Implication for practice : There is little evidence to indicate which dressings or topical agents are the most effective in the treatment of chronic wounds .
However , there is evidence that hydrocolloid dressings are better than wet-to-dry dressings for the treatment of pressure sores .
In the treatment of venous ulcers , low adherent dressings are as effective as hydrocolloid dressings beneath compression b and aging .