Effectiveness of hyaluronic acid for treating diabetic foot: a systematic review and meta-analysis

Diabetic foot ulceration is a major complication of diabetes mellitus. Hyaluronic acid (HA) is used in the treatment of diabetic foot. This meta-analysis was designed to evaluate if HA increased the complete healing rate of diabetic foot compared with controls. We searched Medline, Cochrane, EMBASE, Google Scholar (until January 31, 2014) databases for prospective randomized controlled trials that assessed the effectiveness of HA in treating foot ulcers resulting from diabetes. The primary outcome for the study was complete healing rate of the ulcer at 12 weeks. Three hundred twenty-eight patients were identified from four studies that evaluated the rate of healing of diabetic foot that were treated with HA or controls. Among the four studies, odd ratios (OR) ranged from 1.19 to 8.86, with the overall OR being 1.71 (p = 0.047; 95% confidence interval = 1.01 to 2.90). In summary, our meta-analysis strengthens the findings that HA is beneficial in treating diabetic foot by increasing the rate of wound healing. These findings support the use of HA in treating diabetic foot.