Authors' objectives:

To assess the clinical effectiveness and cost- effectiveness of: 1. pressure-relieving beds, mattresses and cushions for pressure sore prevention and treatment 2. compression therapy for the prevention and treatment of leg ulcers 3. low-level laser therapy, therapeutic ultrasound, electrotherapy and electromagnetic therapy for the treatment of chronic wounds.

Authors' results and conclusions: Beds, mattresses and cushions for pressure sore prevention and treatment: A total of 45 RCTs were identified, of which 40 compared different mattresses, mattress overlays and beds. Only two trials evaluated cushions, one evaluated the use of sheepskins, and two looked at turning beds/kinetic therapy. Compression for leg ulcers: A total of 24 trials reporting 26 comparisons were were included (two of prevention and 24 of treatment strategies). Low-level laser therapy, therapeutic ultrasound, electrotherapy and electromagnetic therapy: Four RCTs of laser (for venous leg ulcers), 10 of therapeutic ultrasound (for pressure sores and venous leg ulcers), 12 of electrotherapy (for ischaemic and diabetic ulcers, and chronic wounds generally) and five of electromagnetic therapy (for venous leg ulcers and pressure sores) were included. Studies were generally small, and of poor methodological quality.

Authors' recommendations: Foam alternatives to the standard hospital foam mattress can reduce the incidence of pressure sores in people at risk, as can pressure-relieving overlays on the operating table. One study suggests that air-fluidised therapy may increase pressure sore healing rates. Compression is more effective in healing venous leg ulcers than is no compression, and multi--layered high compression is more effective than single-layer compression. High-compression hosiery was more effective than moderate compression in preventing ulcer recurrence. There is generally insufficient reliable evidence to draw conclusions about the contribution of laser therapy, therapeutic ultrasound, electro-therapy and electromagnetic therapy to chronic wound healing.

Authors' methods: Systematic review

Project Status: Completed

URL for project: http://www.hta.ac.uk/9120130

Year Published: 2001

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: England, United Kingdom

Organisation Name: NIHR Health Technology Assessment programme

Contact Address: NIHR Journals Library, National Institute for Health and Care Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK

Contact Name: journals.library@nihr.ac.uk

Contact Email: journals.library@nihr.ac.uk

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