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Review: little evidence exists for type of dressing or support surface or for nutritional supplements for pressure ulcersCommentary

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Question

Are different treatments effective for pressure ulcers?

Review scope

Included studies were randomised controlled trials (RCTs) published in English that reported outcomes that included wound size or complete healing.

Review methods

Medline, EMBASE/Excerpta Medica, and CINAHL (all to Aug 2008) were searched for RCTs. Journals were hand searched to find other articles. 103 RCTS (n = 5889) were included. Trials were assessed for study quality (“good” [score ⩾4] versus “suboptimal” [score ⩽3] based on methodological criteria [maximum score  =  6]), clinical setting, and source of funding.

Main results

Clinical heterogeneity precluded valid pooling of study results. 12 RCTs (n = 1214) evaluated support surfaces. 4 lower-quality RCTs of 6 total RCTs reported a benefit for powered support surfaces compared with non-powered support surfaces. 5 RCTs compared different types of powered support surfaces. 1 RCT showed that air-fluidised mattresses reduced wound surface area, whereas alternating pressure mattresses covered with foam …

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