Efficacy of Reactive Oxygen Species-Enriched Dressings Compared With Antimicrobial Silver-Based Dressings in Chronic Colonized Wounds: A Randomized Clinical Trial

OBJECTIVE: Chronic wounds have increased due to the aging population and concomitant comorbidities. The wounds in this study persisted more than 4 weeks and were mostly colonized, requiring a local treatment with antimicrobial dressings, such as anti-adherent silver ones. However, silver dressings can have negative effects and limited long-term success, necessitating alternative solutions. Reactive oxygen dressings are natural dressings based on the stimulation of reactive oxygen species that promote wound healing. This study sought to evaluate the efficacy of an oxygen-enriched oleic matrix dressing compared with an antimicrobial silver dressing. METHODS: A comparative efficacy randomized, controlled, parallel-arm, double-blind clinical trial was conducted. Eighty-one adult patients with colonized chronic wounds were recruited and randomly allocated (2:1 ratio) to the experimental group (reactive oxygen dressing) or the control group (silver dressing). Primary outcomes included wound area and characteristics (edges, depth, tissue, and exudate presence). Secondary outcomes included colonization status and patient-reported pain. Data were analyzed using inferential statistics. RESULTS: The findings showed improvements in the reactive oxygen-dressing group compared with the silver dressing group. Wound area reduced by 60.9% in the experimental group versus 38.7% in the control group. Colonization rates also dropped significantly, with 40.7% in the experimental group achieving culture negativity versus 9.9% in the control group. Both groups experienced reductions in pain, but the reactive oxygen-dressing group achieved a greater overall mean reduction. CONCLUSIONS: These findings underscore reactive oxygen dressings as an effective and natural alternative to silver dressings, promoting faster healing, reducing pain, and colonization within a month. Further studies on cost efficacy are recommended.