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 area/size reduction | Hyperbaric oxygen therapy (systemic + usual care) | NA | NA | NA | – |
Stem cell therapy | NA | NA | NA | + | |
Time to healing or rate of healing (MAs: NA; non-MAs: 3) | Human skin equivalent | NA | NA | NA | + |
Human cultured dermis | NA | NA | NA | – | |
Laser therapy and complex intervention | NA | NA | NA | +/− | |
Platelet derived growth factors (topical) | NA | NA | NA | + | |
 | Pressure off-loading, felted foam | NA | NA | NA | – |
 | Pressure off-loading, total contact or non-removable cast | NA | NA | NA | + |
 | Stem cell therapy | NA | NA | NA | – |
 | Skin grafts | NA | NA | NA | – |
 | Topical negative pressure | NA | NA | – | NA |
Ulcer healing | Chinese herbal medicine + standard therapy | NA | + | NA | NA |
Granulocyte colony-stimulating factor (SC, IV) + antibiotics (oral, IV) | +/− | – | NA | +/− | |
 | Alginate, foam, hydrogel, hydrocolloid dressings | NA | NA | NA | +/− |
 | Alginate, hydrogel, hydrocellulose, semi-permeable membrane dressings | NA | NA | NA | – |
 | Amoxicillin + clavulanic acid (oral), ofloxacin, imipenem/cilastatin, ampicillin/sulbactam (IV) | NA | NA | NA | +/− |
 | Antibiotics, choice based on bone biopsy (IV, oral) | NA | NA | NA | +/− |
 | Ayurvedic preparations (oral + topical) | NA | NA | NA | +/− |
 | Clindamycin, fluoroquinolone, rifampicin, amoxicillin/clavulanic acid (oral, topical) +/− surgical intervention | NA | NA | NA | +/− |
 | Compression | NA | NA | NA | + |
 | Cultured human dermis | NA | NA | NA | +/− |
 | Dressings + debridement (hydrogel) | NA | NA | NA | + |
 | Early surgical intervention + antibiotics | NA | NA | NA | +/− |
 | Electrical stimulation | NA | NA | NA | – |
 | Endovascular or open bypass revascularization surgery of an ulcerated foot | NA | NA | NA | +/− |
 | Foot care clinic interventions | NA | NA | NA | +/− |
 | Growth factors (topical) | NA | NA | NA | – |
 | Hydrogel, cadexomer iodine ointment, dressings, larval therapy, sugar (topical) systemic antibiotics | NA | NA | NA | +/− |
 | Hyperbaric oxygen therapy | NA | NA | NA | +/− |
 | Hyperbaric oxygen therapy (systemic + usual care) | NA | NA | NA | – |
 | Imipenem/cilastatin, cefazolin, Ampicillin/sulbactam, Linezolid, Piperacillin/tazobactam. Amoxycillin + clavulanic acid, clindamycin hydrochloride (oral), pexiganan cream | NA | NA | – | NA |
 | Ketanserin (oral, topical) | NA | NA | NA | +/− |
 | Larval therapy | NA | NA | NA | + |
 | Lyophilized collagen, platelets and derived products (topical) | NA | NA | NA | + |
 | Magnet and normothermic therapy | NA | NA | NA | – |
 | Patient education | NA | NA | NA | +/− |
 | Percutaneous flexor tenotomy | NA | NA | NA | +/− |
 | Procaine + polyvinylpyrrolidone (IM) | NA | NA | NA | – |
 | Resection of the complex wound | NA | NA | NA | – |
 | Sharp debridement | NA | NA | NA | +/− |
 | Skin grafts | NA | NA | NA | + |
 | Stem cell therapy | NA | NA | NA | + |
 | Superoxidized water and soap, povidone iodine (topical) | NA | NA | NA | +/− |
 | Therapeutic footwear | NA | NA | NA | +/− |
 | Thrombin-induced human platelet growth factor, recombinant platelet derived growth factor, recombinant basic fibroblast growth factor,arginine-glycine-aspartic acid peptide matrix (topical) | NA | NA | NA | +/− |
 | Topical negative pressure | NA | NA | NA | + |
 | Negative pressure therapy | NA | NA | NA | + |
 | Total contact casting | NA | NA | NA | +/− |
 | Ultrasound | NA | NA | NA | – |
 | Zinc oxide tape | NA | NA | NA | + |
No healing improvement/non-healed wounds (MAs: 5) | Chinese herbal medicine | NA | + | NA | NA |
Hyaluronic acid-based scaffold and keratinocytes | – | NA | NA | NA | |
 | Hyaluronic acid-based derivative | + | NA | NA | NA |
 | Low frequency low intensity noncontact ultrasound | + | NA | NA | NA |
Proportion of patients with healed wounds | Alginate dressing | – | NA | NA | NA |
Artificial skin graft and standard care | NA | + | NA | NA | |
Chinese herbal medicine plus standard treatment | NA | + | NA | NA | |
Skin graft (Dermagraft) | NA | – | NA | NA | |
 | Fibrous-hydrocolloid (hydrofibre) dressing | – | NA | NA | NA |
Foam dressing | – | NA | NA | NA | |
 | Granulocyte colony-stimulating factor (SC, IV) + antibiotics (oral, IV) | + | + | NA | NA |
Hyaluronic acid-based scaffold and keratinocytes | – | NA | NA | NA | |
 | Hydrogel dressing | + | + | NA | NA |
Hyperbaric oxygen therapy | – |  | NA | NA | |
 | Platelet-rich plasma | NA | + | NA | NA |
Skin replacement therapy (keratinocyte allograft, meshed skin autograft, split thickness autograft) | NA | + | NA | NA |