Evidence-based decisions for local and systemic wound care

F E Brölmann, D T Ubbink, E A Nelson, K Munte, C M A M van der Horst, H Vermeulen

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Decisions on local and systemic wound treatment vary among surgeons and are frequently based on expert opinion. The aim of this meta-review was to compile best available evidence from systematic reviews in order to formulate conclusions to support evidence-based decisions in clinical practice.

METHODS: All Cochrane systematic reviews (CSRs), published by the Cochrane Wounds and Peripheral Vascular Diseases Groups, and that investigated therapeutic and preventive interventions, were searched in the Cochrane Database up to June 2011. Two investigators independently categorized each intervention into five levels of evidence of effect, based on size and homogeneity, and the effect size of the outcomes.

RESULTS: After screening 149 CSRs, 44 relevant reviews were included. These contained 109 evidence-based conclusions: 30 on venous ulcers, 30 on acute wounds, 15 on pressure ulcers, 14 on diabetic ulcers, 12 on arterial ulcers and eight on miscellaneous chronic wounds. Strong conclusions could be drawn regarding the effectiveness of: therapeutic ultrasonography, mattresses, cleansing methods, closure of surgical wounds, honey, antibiotic prophylaxis, compression, lidocaine-prilocaine cream, skin grafting, antiseptics, pentoxifylline, debridement, hyperbaric oxygen therapy, granulocyte colony-stimulating factors, prostanoids and spinal cord stimulation.

CONCLUSION: For some wound care interventions, robust evidence exists upon which clinical decisions should be based.

Original languageEnglish
Pages (from-to)1172-83
Number of pages12
JournalBritish Journal of Surgery
Volume99
Issue number9
Early online date6 Jul 2012
DOIs
Publication statusPublished - 2 Aug 2012

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Wounds and Injuries
Ulcer
Prilocaine
Spinal Cord Stimulation
Varicose Ulcer
Pentoxifylline
Hyperbaric Oxygenation
Skin Transplantation
Local Anti-Infective Agents
Honey
Antibiotic Prophylaxis
Peripheral Vascular Diseases
Pressure Ulcer
Expert Testimony
Granulocyte Colony-Stimulating Factor
Debridement
Lidocaine
Prostaglandins
Ultrasonography
Therapeutics

Keywords

  • Acute Disease
  • Chronic Disease
  • Evidence-Based Practice
  • Humans
  • Skin Ulcer/physiopathology
  • Tissue Adhesions/surgery
  • Wound Healing/physiology
  • Wounds and Injuries/physiopathology

Cite this

Brölmann, F. E., Ubbink, D. T., Nelson, E. A., Munte, K., van der Horst, C. M. A. M., & Vermeulen, H. (2012). Evidence-based decisions for local and systemic wound care. British Journal of Surgery, 99(9), 1172-83. https://doi.org/10.1002/bjs.8810
Brölmann, F E ; Ubbink, D T ; Nelson, E A ; Munte, K ; van der Horst, C M A M ; Vermeulen, H. / Evidence-based decisions for local and systemic wound care. In: British Journal of Surgery. 2012 ; Vol. 99, No. 9. pp. 1172-83.
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Brölmann, FE, Ubbink, DT, Nelson, EA, Munte, K, van der Horst, CMAM & Vermeulen, H 2012, 'Evidence-based decisions for local and systemic wound care', British Journal of Surgery, vol. 99, no. 9, pp. 1172-83. https://doi.org/10.1002/bjs.8810

Evidence-based decisions for local and systemic wound care. / Brölmann, F E; Ubbink, D T; Nelson, E A; Munte, K; van der Horst, C M A M; Vermeulen, H.

In: British Journal of Surgery, Vol. 99, No. 9, 02.08.2012, p. 1172-83.

Research output: Contribution to journalArticle

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T1 - Evidence-based decisions for local and systemic wound care

AU - Brölmann, F E

AU - Ubbink, D T

AU - Nelson, E A

AU - Munte, K

AU - van der Horst, C M A M

AU - Vermeulen, H

N1 - Copyright © 2012 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. Acceptance from webpage.

PY - 2012/8/2

Y1 - 2012/8/2

N2 - BACKGROUND: Decisions on local and systemic wound treatment vary among surgeons and are frequently based on expert opinion. The aim of this meta-review was to compile best available evidence from systematic reviews in order to formulate conclusions to support evidence-based decisions in clinical practice.METHODS: All Cochrane systematic reviews (CSRs), published by the Cochrane Wounds and Peripheral Vascular Diseases Groups, and that investigated therapeutic and preventive interventions, were searched in the Cochrane Database up to June 2011. Two investigators independently categorized each intervention into five levels of evidence of effect, based on size and homogeneity, and the effect size of the outcomes.RESULTS: After screening 149 CSRs, 44 relevant reviews were included. These contained 109 evidence-based conclusions: 30 on venous ulcers, 30 on acute wounds, 15 on pressure ulcers, 14 on diabetic ulcers, 12 on arterial ulcers and eight on miscellaneous chronic wounds. Strong conclusions could be drawn regarding the effectiveness of: therapeutic ultrasonography, mattresses, cleansing methods, closure of surgical wounds, honey, antibiotic prophylaxis, compression, lidocaine-prilocaine cream, skin grafting, antiseptics, pentoxifylline, debridement, hyperbaric oxygen therapy, granulocyte colony-stimulating factors, prostanoids and spinal cord stimulation.CONCLUSION: For some wound care interventions, robust evidence exists upon which clinical decisions should be based.

AB - BACKGROUND: Decisions on local and systemic wound treatment vary among surgeons and are frequently based on expert opinion. The aim of this meta-review was to compile best available evidence from systematic reviews in order to formulate conclusions to support evidence-based decisions in clinical practice.METHODS: All Cochrane systematic reviews (CSRs), published by the Cochrane Wounds and Peripheral Vascular Diseases Groups, and that investigated therapeutic and preventive interventions, were searched in the Cochrane Database up to June 2011. Two investigators independently categorized each intervention into five levels of evidence of effect, based on size and homogeneity, and the effect size of the outcomes.RESULTS: After screening 149 CSRs, 44 relevant reviews were included. These contained 109 evidence-based conclusions: 30 on venous ulcers, 30 on acute wounds, 15 on pressure ulcers, 14 on diabetic ulcers, 12 on arterial ulcers and eight on miscellaneous chronic wounds. Strong conclusions could be drawn regarding the effectiveness of: therapeutic ultrasonography, mattresses, cleansing methods, closure of surgical wounds, honey, antibiotic prophylaxis, compression, lidocaine-prilocaine cream, skin grafting, antiseptics, pentoxifylline, debridement, hyperbaric oxygen therapy, granulocyte colony-stimulating factors, prostanoids and spinal cord stimulation.CONCLUSION: For some wound care interventions, robust evidence exists upon which clinical decisions should be based.

KW - Acute Disease

KW - Chronic Disease

KW - Evidence-Based Practice

KW - Humans

KW - Skin Ulcer/physiopathology

KW - Tissue Adhesions/surgery

KW - Wound Healing/physiology

KW - Wounds and Injuries/physiopathology

U2 - 10.1002/bjs.8810

DO - 10.1002/bjs.8810

M3 - Article

C2 - 22777856

VL - 99

SP - 1172

EP - 1183

IS - 9

ER -

Brölmann FE, Ubbink DT, Nelson EA, Munte K, van der Horst CMAM, Vermeulen H. Evidence-based decisions for local and systemic wound care. British Journal of Surgery. 2012 Aug 2;99(9):1172-83. https://doi.org/10.1002/bjs.8810