Departments of Dermatology, Medicine and Surgery, School of Medicine, Johns Hopkins University, Queenstown, Maryland.
Wound Repair Regen. 2014 Jan-Feb;22(1):34-42. doi: 10.1111/wrr.12102. Epub 2013 Oct 17.
The prevalence and costs of chronic venous ulcer care in the US are increasing. The Johns Hopkins University Evidence-Based Practice Center recently completed a systematic review of the comparative effectiveness of advanced wound dressings, antibiotics, and surgical management of chronic venous ulcers. Of 10,066 citations identified in the literature search, only 66 (0.06%) met our liberal inclusion criteria for providing evidence on the effectiveness of interventions for chronic venous ulcers. Based on review of those studies, members of our team and a panel of informed stakeholders identified important research gaps and methodological deficiencies and prioritized specific future research needs. Based on that review, we provide the results of our assessment of future research needs for chronic venous ulcer care. Advanced wound dressings were considered to have the highest priority for future research, followed by venous surgery and antibiotics. An imperative from our assessment is that future research evaluating interventions for chronic venous ulcers meet quality standards. In a time of increasing cost pressure, the wound care community needs to develop high-quality evidence to justify the use of present and future therapeutic modalities.
美国慢性静脉性溃疡护理的患病率和费用正在不断增加。约翰霍普金斯大学循证实践中心最近对慢性静脉性溃疡的高级伤口敷料、抗生素和手术治疗的比较效果进行了系统评价。在文献检索中确定了 10066 条引文,只有 66 条(0.06%)符合我们对干预慢性静脉性溃疡有效性提供证据的宽松纳入标准。根据对这些研究的审查,我们的团队成员和一组知情利益相关者确定了重要的研究差距和方法学缺陷,并确定了特定的未来研究需求。基于该审查,我们提供了对慢性静脉性溃疡护理未来研究需求的评估结果。高级伤口敷料被认为是未来研究的重中之重,其次是静脉手术和抗生素。我们的评估提出了一个强制性要求,即未来评估慢性静脉性溃疡干预措施的研究要符合质量标准。在成本压力不断增加的情况下,伤口护理界需要制定高质量的证据来证明目前和未来治疗方式的使用是合理的。