Effectiveness of Different Topical Treatments in the Healing of Pressure Injuries: A Network Meta-analysis

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dc.contributor.authorFuruya-Kanamori, Luis
dc.contributor.authorWalker, Rachel M.
dc.contributor.authorGillespie, Brigid M.
dc.contributor.authorClark, Justin
dc.contributor.authorDoi, Suhail A R
dc.contributor.authorThalib, Lukman
dc.date.accessioned2020-11-25T02:48:34Z
dc.date.issued2019
dc.date.updated2020-07-19T08:28:11Z
dc.description.abstractObjectives Pressure injuries (PIs) are one of the most common types of complex wounds and impose a huge economic burden on the healthcare system and the patients. A plethora of topical treatments is widely available for PI treatment, yet there is a paucity of evidence with regard to the most effective treatment. The objective of this study was to compare the effect of various topical treatments and identify the best treatment choice(s) for PI healing. Design Systematic review and network meta-analysis. Setting and participants All published randomized controlled trials that compared the effectiveness of 2 or more of the following dressing groups: basic, foam, active, hydroactive, and other wound dressings. Measures The outcome was the relative risk (RR) of complete healing following treatment and the generalized pairwise modeling framework was used to generate mixed treatment effects against hydroactive wound dressing, currently the standard of treatment for PIs. All treatments were then ranked by their point estimates. Results 40 studies (1757 participants) comparing 5 dressing groups were included in the analysis. All dressings groups ranked better than basic (ie, saline gauze or similar inert dressing). The foam [RR 1.18; 95% confidence interval (CI) 0.95-1.48] and active wound dressing (RR 1.16; 95% CI 0.92-1.47) ranked better than hydroactive wound dressing in terms of healing of PIs when the latter was used as the reference group. Conclusions/Implications There was substantial uncertainty around the point estimates; however, evidence from our analysis supports the use of hydroactive wound dressings to replace basic dressings. Foam and active wound dressing groups seem promising and therefore need further investigation. High-quality, rigorously conducted research about the clinical effectiveness of the topical treatments in these 2 groups developed in consultation with health professionals, patients, and their carers is needed to identify if indeed foam and active wound dressings provide advantages over hydroactive dressings.en_AU
dc.format.mimetypeapplication/pdfen_AU
dc.identifier.issn1525-8610en_AU
dc.identifier.urihttp://hdl.handle.net/1885/216374
dc.language.isoen_AUen_AU
dc.publisherElsevieren_AU
dc.rights© 2018 AMDA - The Society for Post-Acute and Long-Term Care Medicine © Elsevier Inc.en_AU
dc.sourceJournal of the American Medical Directors Associationen_AU
dc.titleEffectiveness of Different Topical Treatments in the Healing of Pressure Injuries: A Network Meta-analysisen_AU
dc.typeJournal articleen_AU
local.bibliographicCitation.issue4en_AU
local.bibliographicCitation.lastpage407en_AU
local.bibliographicCitation.startpage399en_AU
local.contributor.affiliationFuruya Kanamori, Luis, College of Health and Medicine, ANUen_AU
local.contributor.affiliationWalker, Rachel M., Griffith Universityen_AU
local.contributor.affiliationGillespie, Brigid M., Griffith Universityen_AU
local.contributor.affiliationClark, Justin, Faculty of Health Sciences and Medicine, Bond Universityen_AU
local.contributor.affiliationDoi, Suhail A R, Qatar Universityen_AU
local.contributor.affiliationThalib, Lukman, Qatar Universityen_AU
local.contributor.authoremailu5127170@anu.edu.auen_AU
local.contributor.authoruidFuruya Kanamori, Luis, u5127170en_AU
local.description.embargo2037-12-31
local.description.notesImported from ARIESen_AU
local.identifier.absfor111706 - Epidemiologyen_AU
local.identifier.absseo920412 - Preventive Medicineen_AU
local.identifier.ariespublicationa383154xPUB12933en_AU
local.identifier.citationvolume20en_AU
local.identifier.doi10.1016/j.jamda.2018.10.010en_AU
local.identifier.uidSubmittedBya383154en_AU
local.publisher.urlhttps://www.elsevier.com/en-auen_AU
local.type.statusPublished Versionen_AU

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