Tayyib Nahla
Faculty of Nursing, Umm-AlQura University, Makkah, Saudi Arabia.
J Wound Care. 2022 Jun 2;31(6):520-531. doi: 10.12968/jowc.2022.31.6.520.
To synthesise the best available evidence regarding the effectiveness of using topical haemoglobin spray to promote healing in hard-to-heal wounds in adults.
The search strategy of this systematic review was designed to retrieve studies published across CINAHL, Medline, Cochrane Central Register of Controlled Trials, Web of Science, Embase, ERIC, Scopus and Mednar, before January 2020, and published in English. All study participants were aged ≥18 years. This review included randomised controlled trials, case-control studies and observational studies. The studies selected for retrieval were assessed by two independent reviewers for methodological validity prior to inclusion using standardised critical appraisal instruments.
The review included 15 studies. Overall effectiveness was demonstrated for wound closure rates, reductions in wound size, severity of wound pain and patient satisfaction with using a topical haemoglobin spray. The meta-analysis revealed a statistically significant effect of a topical haemoglobin spray in reducing the size of venous leg ulcers (VLU, effect size=0.02; 95% confidence interval: 0.00-0.09; p<0.00001) in adult patients. However, evidence of the effectiveness of using a topical haemoglobin spray in different wound types among adult patients was limited and not high-level, which precludes any strong conclusions.
The review provides an evidence-based guide to future priorities for clinical practice. In particular, a topical haemoglobin spray was shown to have a positive impact in reducing VLU size and promoting wound healing.
综合现有最佳证据,探讨外用血红蛋白喷雾剂对促进成人难愈合伤口愈合的有效性。
本系统评价的检索策略旨在检索2020年1月前发表在CINAHL、Medline、Cochrane对照试验中央注册库、科学网、Embase、ERIC、Scopus和Mednar上且为英文发表的研究。所有研究参与者年龄≥18岁。本评价纳入随机对照试验、病例对照研究和观察性研究。在纳入之前,由两名独立 reviewers 使用标准化的批判性评价工具对选定检索的研究进行方法学有效性评估。
该评价纳入了15项研究。外用血红蛋白喷雾剂在伤口闭合率、伤口大小减小、伤口疼痛严重程度以及患者满意度方面均显示出总体有效性。荟萃分析显示,外用血红蛋白喷雾剂对成年患者静脉性腿部溃疡(VLU)大小的减小有统计学显著效果(效应量=0.02;95%置信区间:0.00 - 0.09;p<0.00001)。然而,关于外用血红蛋白喷雾剂在成年患者不同伤口类型中的有效性证据有限且并非高级别,这使得无法得出任何有力结论。
该评价为未来临床实践的优先事项提供了循证指南。特别是,外用血红蛋白喷雾剂在减小VLU大小和促进伤口愈合方面显示出积极影响。