From: Seeking effective interventions to treat complex wounds: an overview of systematic reviews
Outcome | Intervention | Systematic reviews with MA | Systematic reviews without MA | ||
---|---|---|---|---|---|
High-quality* | Low/moderate quality | High-quality** | Low/moderate quality | ||
Wound size reduction | Cadexomer iodine (topical) | + | NA | NA | NA |
Micronized purified flavonoid fraction (MPFF) (oral) | NA | + | NA | NA | |
Time to healing or rate of healing non-MAs: 1 [77]) | Four-layer bandage | + | NA | NA | NA |
MPFF (oral) | NA | + | NA | NA | |
Stockings | NA | + | NA | +/− | |
Silver-impregnated dressings | NA | – | NA | NA | |
 | Applied freeze-dried keratinocyte lysate (topical) | NA | NA | NA | – |
 | Collagenase (topical) | NA | NA | NA | +/− |
 | Compression stockings | NA | NA | NA | + |
 | Flavonoids + compression | NA | NA | NA | +/− |
 | Intermittent pneumatic compression + compression | NA | NA | NA | +/− |
 | Larval therapy | NA | NA | NA | +/− |
 | Laser therapy | NA | NA | NA | +/− |
 | Leg ulcer clinics, wound care program | NA | NA | NA | +/− |
 | Multi-layer elastomeric high-compression | NA | NA | NA | – |
 | Platelet-derived growth factor (oral) | NA | NA | NA | +/− |
 | Rutosides (oral) | NA | NA | NA | +/− |
 | Semi-occlusive dressings: foam, film, hyaluronic acid-derived dressings, collagen, cellulose, or alginate | NA | NA | NA | – |
 | Stockings: multi-layer elastic system, multi-layer elastomeric (or non-elastomeric) high-compression regimens | NA | NA | NA | – |
 | Sulodexide (oral) + compression | NA | NA | NA | + |
 | Thromboxane α2 antagonists (oral) | NA | NA | NA | +/− |
 | Topical negative pressure (vacuum-assisted closure) | NA | NA | NA | + |
 | Ultrasound | NA | NA | NA | – |
Ulcer healing | Elastic high compression bandages | + | NA | NA | + |
Cryopreserved allografts (Skin grafting) | NA | – | NA | +/− | |
 | Cultured keratinocytes/epidermal grafts (Skin grafting) | NA | – | NA | +/− |
 | Fresh allografts (Skin grafting) | NA | – | NA | +/− |
 | Granulocyte-macrophage colony stimulating factor (topical) | NA | + | NA | NA |
 | Pentoxifylline (oral) | + | NA | NA | NA |
 | Stockings | NA | + | NA |  |
 | Tissue engineered skin | NA | + | NA | NA |
 | Electromagnetic therapy | NA | NA | + | NA |
 | Hydrocolloid (occlusive) dressings + compression | NA | NA | NA | – |
 | Intermittent pneumatic compression (Flowtron, sequential gradient Jobst extremity pump) | NA | NA | NA | +/− |
 | Maggot debridement therapy | NA | NA | NA | + |
 | Mesoglycan (topical) | NA | NA | NA | +/− |
 | Superficial venous surgery | NA | NA | + | NA |
Proportion of patients with healed wounds (MAs: 39 [21,23,25,30,31,36,40,45,46,48,52,53,55,58,62,64-67]; | Four-layer bandage | – | NA |  |  |
Any laser (unspecified low level laser, ultraviolet therapy, non-coherent unpolarized red light) | NA | – | NA | NA | |
 | Artificial skin graft and standard wound care | NA | – | NA | NA |
 | Autologous platelet-rich plasma (topical) | NA | – | NA | – |
 | Cadexomer iodine (topical) plus compression therapy | + | NA | NA | NA |
 | Systemic ciprofloxacin (oral) | NA | – | NA | NA |
 | Skin replacement therapy (Dermagraft) | NA | + | NA | + |
 | Elastic high compression bandages | + | NA | NA | NA |
 | Foam dressing | – | NA | NA | NA |
 | Granulocyte-macrophage colony stimulating factor (perilesional injection) | NA | + | NA | + |
 | High frequency ultrasound | – | NA | NA | NA |
 | Honey (topical) | – | NA | NA | NA |
 | Hydrocolloid dressings | – | NA | NA | NA |
 | Hydrogel dressing | – | NA | NA | NA |
 | Intermittent pneumatic compression stockings | +/− | – | NA | NA |
 | Low frequency ultrasound | – | NA | NA | NA |
 | Multi-layer high compression bandages | +/− | NA | NA | + |
 | Pentoxifylline (oral) with and without compression | + | NA | NA | + |
 | Stockings | + | NA | NA | +/− |
 | Two-component (outer elastic) bandages | +/− | NA | NA | NA |
 | Ultrasound | NA | – | NA | NA |
 | Unna’s boot | NA | – | NA | NA |
 | Zinc (oral) | – | NA | NA | NA |
 | Antimicrobial (topical) | NA | NA | NA | – |
 | Calcitonin gene-related peptide (topical) | NA | NA | NA | – |
 | Prostaglandin EI (IV) | NA | NA | NA | + |
 | Subfascial endoscopic perforator surgery | NA | NA | NA | + |
 | Superficial vein surgery | NA | NA | NA | +/− |
 | Systemic mesoglycan (IM, oral) + compression | NA | NA | NA | + |