Table 6 Summary of evidence for mixed complex wounds management
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 (MAs:5) [21,32,41,42] | Autologous platelet-rich plasma/platelet-rich plasma (topical) | – | – | NA | NA |
| Silver releasing dressings | + | NA | NA | NA | |
| Topical negative pressure | NA | + | NA | NA | |
| Ulcer healing (MA: 1 [63]; non-MAs: 5 [91,100,105,107,111]) | Laser therapy | NA | – | NA | NA |
| Adhesive zinc oxide tape | NA | NA | + | NA | |
| Dextranomer polysaccharide beads or paste, cadexomer iodine polysaccharide beads or paste | NA | NA | _ | NA | |
| Enzymatic agents (topical) | NA | NA | – | NA | |
| Hydrogel dressings | NA | NA | – | NA | |
| Hyperbaric oxygen therapy | NA | NA | NA | + | |
| No-sting barrier film bandages | NA | NA | NA | + | |
| Silver releasing dressing, non-releasing silver-activated charcoal dressing, hydrocolloid silver Vaseline-impregnated dressing, silver coated dressing, hydrocolloid silver-releasing dressing, silver-releasing foam dressing | NA | NA | + | NA | |
| Topical negative pressure (open-cell foam dressing with continuous suction) | NA | NA | + | NA | |
| Proportion of patients with healed wounds (MAs: 10) [21,55,58,61,62,125] | Skin replacement (skin substitute) and standard care | NA | + | NA | NA |
| Skin replacement (dermal substitute) and standard care | NA | + | NA | NA | |
| Artificial skin grafts and standard care | NA | + | NA | NA | |
| Autologous platelet-rich plasma/platelet-rich plasma (topical) | NA | – | NA | NA | |
| Hydrocolloid dressings | – | + | NA | NA | |
| Laser therapy | – | NA | NA | NA | |
| Ultrasound | +/− | NA | NA | NA | |