Efficacy and safety of wet wrap therapy for patients with atopic dermatitis: a systematic review and meta-analysis

Abstract

Background

Wet wrap therapy (WWT) consists of topical steroids administered under a layer of wet cotton bandages or garments. Several trials with WWT have reported promising results in atopic dermatitis (AD). However, no systematic review and meta-analysis on its efficacy and safety has been published.

Objectives

To systematically review the literature on WWT in AD to assess its efficacy and safety.

Methods

We included randomized controlled trials among patients of all ages with a diagnosis of AD based on predefined criteria or performed by a dermatologist. Electronic searches were performed from 1970 to March 30, 2016, in the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE and the WHO International Clinical Trials Registry. Selection of studies and data extraction was performed independently by two researchers, and discrepancies were resolved by consensus.

Results

6 trials comparing WWT against topical steroids in children or adults with AD were included. Sample sizes ranged from 19 to 51 patients. Results on clinical severity and quality of life were reported incompletely and proved heterogeneous across studies. A nonsignificant tendency to increased risk of mild skin infections was observed in those treated with WWT (pooled relative risk 6.35; 95% confidence interval 0.83 to 48.55). The overall grade of quality of evidence for the efficacy and safety outcomes was low.

Conclusions

The evidence that WWT is more effective than conventional treatment with topical steroids in AD is of low quality. Further clinical trials should establish the efficacy of WWT in AD.

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