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 | Air-fluidized support | NA | NA | NA | + |
Alternating pressure mattress, low-air-loss mattress, air-fluidized mattress | NA | NA | NA | – | |
 | Collagenase | NA | NA | NA | +/− |
 | Collagenase, hydrogel dressings | NA | NA | NA | – |
 | Electric current, electromagnetic therapy | NA | NA | NA | – |
 | Foam, calcium alginate, radiant heat dressing, dextranomer powder dressings | NA | NA | NA | – |
 | Hydrocolloid dressings | NA | NA | NA | + |
 | Hydrocolloid, hydrogel wafer, hydrogel, occlusive polyurethane, transparent moisture-permeable dressings | NA | NA | NA | – |
 | Hydrogel, cadexomer iodine, semelil gel, radiant heat, zinc salt spray, aluminum hydroxide, vitamin A ointment, streptokinase-streptodornase, dialysate, topical insulin, moist saline gauze and whirlpool, semelil dressings | NA | NA | NA | – |
 | Low level laser therapy, laser and standard care | NA | NA | NA | – |
 | Polarized light, monochromatic light and cadexomer iodine or hydrocolloid | NA | NA | NA | – |
 | Ultrasound | NA | NA | NA | – |
 | Vacuum therapy | NA | NA | NA | – |
 | Vitamin C and ultrasound, consistent wound care and controlled nutritional support, vitamin C, zinc sulfate | NA | NA | NA | – |
Time to healing or rate of healing | Ascorbic acid, high-protein diet, concentrated, fortified, collagen protein hydrolysate supplement, disease-specific nutrition treatment | NA | NA | NA | +/− |
 | Amorphous hydrogel dressing derived from Aloe vera wound dressings | NA | NA | +/− | NA |
 | Electromagnetic therapy, low-intensity direct current, negative-polarity and positive-polarity electrotherapy, and alternating-polarity electrotherapy | NA | NA | NA | +/− |
 | Hydrocolloid dressings | NA | NA | NA | +/− |
 | Low air-loss beds | NA | NA | NA | +/− |
 | Low level laser therapy | NA | NA | NA | +/− |
 | Low-tech constant low-pressure supports | NA | NA | NA | +/− |
 | Phenytoin ointment (topical) | NA | NA | NA | +/− |
 | Seat cushions | NA | NA | NA | +/− |
 | Topical negative pressure | NA | NA | NA | +/− |
 | Triple antibiotic ointment, active cream dressings | NA | NA | NA | – |
 | Ultrasound | NA | NA | NA | – |
Ulcer healing | Air-fluidized bed/supports | + | + | +/− | NA |
Air-fluidized beds, air suspension beds, foam replacement mattress | NA | NA | – | NA | |
 | Alternating pressure surfaces | NA | NA |  | +/− |
 | Alternating pressure surfaces (alternating pressure mattress + pressure relief cushion) | NA | NA | +/− | NA |
 | Ascorbic acid, zinc sulfate | NA | NA | +/− | NA |
 | Collagen protein, standard hospital diet and high protein, standard hospital diet and high protein and zinc and arginine and vitamin C | NA | NA | NA | – |
 | Collagenase (topical) | NA | NA | NA | + |
 | Fibroblast-derived dermal replacement | NA | NA | NA | + |
 | Hydrocolloid, polyurethane, dextranomer, hydrogel, polyhydroxyethyl methacrylate, amino acid copolymer dressings | NA | NA | NA | – |
 | Low air-loss mattress, alternating pressure mattress, air-fluidized mattress | NA | NA | NA | – |
 | Phenytoin solution, antibiotics dressings | NA | NA | NA | – |
 | Protease-modulating matrix, recombinant platelet-derived growth factor BB, nerve growth factor, transforming growth factor beta, granulocyte-macrophage/colony stimulating factor, basic fibroblast growth factor (topical) | NA | NA | NA | + |
 | Saline spray containing Aloe vera, silver chloride and decyl glucoside, saline, whirlpool | NA | NA | NA | – |
 | Topical negative pressure | NA | NA | NA | – |
 | Topical negative pressure (vacuum assisted wound closure) | NA | NA | NA | – |
 | Alternative foam mattress | + | NA | NA | NA |
 | Electrotherapy | + | NA | NA | NA |
 | High protein, oral nutritional support, enteral tube feeding | – | NA | NA | NA |
 | Hydrocolloid dressings | + | NA | NA | NA |
 | Polyurethane dressings | – | NA | NA | NA |
Proportion of patients with healed wounds | Collagenase debridement (topical) | NA | – | NA | NA |
Dextranomer (beads + dry dressing) | NA | – | NA | NA | |
Electrical stimulation | NA | – | NA | NA | |
 | Electrotherapy | NA | – | NA | – |
 | Growth Factors (topical) | NA | – | NA |  |
 | Hydrocolloid dressings | NA | +/− | NA | – |
 | Hydrogel (gel) | NA | + | NA | – |
 | Hydropolymer dressing | NA | – | NA | NA |
 | Low air-loss beds | – | – | NA | NA |
 | Low level laser therapy | NA | – | NA | NA |
 | Alternating pressure mattress | NA | +/− | NA | NA |
 | Non-contact normothermic dressing | NA | – | NA | NA |
 | Polyurethane dressings | NA | – | NA | – |
 | Ultrasound | – | – | NA | +/− |
 | Zinc supplement (oral) | NA | – | NA |  |
 | Collagenase, dressings | NA | NA | NA | – |
 | Laser therapy + moist saline gauze | NA | NA | NA | – |
 | Monochromatic phototherapy, UV light | NA | NA | NA | – |
 | Oxyquinoline, radiant heat, soft silicone, hydrogel or foam, active ointment with live yeast derivative, topical insulin (dressings) | NA | NA | NA | – |
 | Resin salve absorbent dressings | NA | NA | NA | – |
 | Specialized foam mattress, alternating pressure mattress | NA | NA | NA | – |