Cochrane reviews allow firm conclusions to be made about the effectiveness of various local and systemic treatments for wounds and ulcers
- School of Nursing, Case Western Reserve University, Cleveland, Ohio, USA
- Correspondence to: Dr Katherine R Jones
School of Nursing, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH 44106-4909, USA;
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 …