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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
  1. *At least one systematic review with meta-analysis and AMSTAR score ≥8.
  2. **At least one systematic review without meta-analysis and AMSTAR score ≥8.
  3. + Effective (statistically significant difference between interventions and comparators); – No difference (no statistically significant difference between interventions and comparators); +/− Unknown (conflicting evidence between meta-analysis or indeterminate results); NA, No studies available); MA, Meta-analysis.