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Systematic review
Cochrane reviews allow firm conclusions to be made about the effectiveness of various local and systemic treatments for wounds and ulcers
  1. Katherine R Jones
  1. School of Nursing, Case Western Reserve University, Cleveland, Ohio, USA
  1. Correspondence to: Dr Katherine R Jones
    School of Nursing, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH 44106-4909, USA; katherine.jones{at}case.edu

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Commentary on: Brölmann FE, Ubbink DT, Nelson EA, et al. Evidence-based decisions for local and systemic wound care. Br J Surg 2012;99:1172–83.

Implications for practice and research

  • Evidence-supported interventions to manage chronic wounds include elastic, high or multilayer compression and systemic pentoxifyllene for venous ulcers; hyperbaric oxygen and local hydrogels applied after debridement for diabetic ulcers; systemic prostanoids and spinal cord stimulation for arterial ulcers; and avoidance of local therapeutic ultrasound for healing pressure ulcers.

  • Evidence-supported interventions to prevent pressure ulcers include high-specification foam and low air-loss mattresses, and pressure-relieving overlays on operating room tables.

  • Evidence-supported interventions for acute wound healing include topical honey for burns, tap water for cleansing soft tissue injury, prophylactic antibiotics for hand bites and avoidance of silver sulfadiazine as a topical agent.

  • Many common wound care therapies have had no trials conducted to assess their effectiveness. More high-quality research studies are urgently needed to determine best practices …

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