Featured Research

from universities, journals, and other organizations

Medical review throws doubt on wound care treatments

Date:
December 23, 2013
Source:
Johns Hopkins Medicine
Summary:
A systematic review of 66 research papers focused on the treatment of skin ulcers suggests that most are so technically flawed that their results are unreliable. And even of those that pass muster, there is only weak evidence that some treatments work better than standard compression therapy or special stockings.

A systematic review of 66 research papers focused on the treatment of skin ulcers suggests that most are so technically flawed that their results are unreliable. And even of those that pass muster, there is only weak evidence that some treatments work better than standard compression therapy or special stockings.

Related Articles


The research review team, led by investigators at the Johns Hopkins Evidence-Based Practice Center and the Johns Hopkins Wound Healing Center, noted than an estimated $25 billion is spent annually in the United States treating chronic skin wounds related mostly to poor blood circulation, disorders known as venous ulcers. Their prevalence is rising along with rates of diabetes and obesity, and the review was undertaken in an effort to inform physicians about the treatment options.

In 2011, the Agency for Healthcare Research and Quality awarded the Johns Hopkins Evidence-Based Practice Center a $475,000 project to carry out the research, which was led by Gerald Lazarus, M.D., founder of the Johns Hopkins Wound Healing Center and professor of dermatology and medicine at Johns Hopkins Bayview Medical Center; and Jonathan Zenilman, M.D., scientific director of the Wound Healing Center and professor of medicine and chief of the Division of Infectious Diseases at Johns Hopkins Bayview.

The research review team began by identifying 10,066 citations that were possibly related to wound care. They found that only 66 of these papers specifically addressed their questions about the effectiveness of treatments for chronic venous leg ulcers.

For the study, the investigators analyzed clinical outcomes involving wound dressings, antibiotics and venous surgery.

Overall results found that dressings that used living human cells increased wound healing. Results suggested that cadexomer iodine and collagen may also increase healing, says Lazarus. "That doesn't mean that other types of dressings don't work. It just means that there is no evidence yet on which treatments work the best," says Lazarus. Support stockings, he adds, must for now remain the standard of care for treating chronic venous ulcers.

Lazarus says the review also showed evidence is inconclusive about using systemic antibiotics unless there are demonstrated signs of infection. And it is also inconclusive about such surgical treatments as radiofrequency ablation, endovenous laser treatment and sclerotherapy helped healing, although surgical correction of underlying pathology did decrease recurrence of ulcers.

"There is a critical need for well-designed research studies to compare the current minimally invasive surgical interventions to the gold standard of care, compression therapy," he says.

The Johns Hopkins researchers enlisted input from a panel of 14 experts in wound care in their review of the data.

Chronic wounds are a global problem, the researchers say. In addition to obesity and diabetes worldwide, skin ulcers occur as a consequence of neurological problems, rheumatological illnesses, blood vessel inflammation and infection. Nonhealing wounds cause not only pain, but also loss of mobility and a general decline in physical and emotional well-being. Patients can become disabled, unable to work and dependent on care from others.

Lazarus says, "The review should serve as a means to bring the wound healing community together to improve the situation." Christine Chang, M.D., M.P.H., medical officer of the Center for Outcomes and Evidence at the Agency for Healthcare Research and Quality, adds, "Our hope is that this evidence report provides patients and providers with the best information available to make well-informed decisions about care."


Story Source:

The above story is based on materials provided by Johns Hopkins Medicine. Note: Materials may be edited for content and length.


Cite This Page:

Johns Hopkins Medicine. "Medical review throws doubt on wound care treatments." ScienceDaily. ScienceDaily, 23 December 2013. <www.sciencedaily.com/releases/2013/12/131223181147.htm>.
Johns Hopkins Medicine. (2013, December 23). Medical review throws doubt on wound care treatments. ScienceDaily. Retrieved December 19, 2014 from www.sciencedaily.com/releases/2013/12/131223181147.htm
Johns Hopkins Medicine. "Medical review throws doubt on wound care treatments." ScienceDaily. www.sciencedaily.com/releases/2013/12/131223181147.htm (accessed December 19, 2014).

Share This


More From ScienceDaily



More Health & Medicine News

Friday, December 19, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Kids Die While Under Protective Services

Kids Die While Under Protective Services

AP (Dec. 18, 2014) As part of a six-month investigation of child maltreatment deaths, the AP found that hundreds of deaths from horrific abuse and neglect could have been prevented. AP's Haven Daley reports. (Dec. 18) Video provided by AP
Powered by NewsLook.com
Dads-To-Be Also Experience Hormone Changes During Pregnancy

Dads-To-Be Also Experience Hormone Changes During Pregnancy

Newsy (Dec. 18, 2014) A study from University of Michigan researchers found that expectant fathers see a decrease in testosterone as the baby's birth draws near. Video provided by Newsy
Powered by NewsLook.com
Prenatal Exposure To Pollution Might Increase Autism Risk

Prenatal Exposure To Pollution Might Increase Autism Risk

Newsy (Dec. 18, 2014) Harvard researchers found children whose mothers were exposed to high pollution levels in the third trimester were twice as likely to develop autism. Video provided by Newsy
Powered by NewsLook.com
UN: Up to One Million Facing Hunger in Ebola-Hit Countries

UN: Up to One Million Facing Hunger in Ebola-Hit Countries

AFP (Dec. 17, 2014) Border closures, quarantines and crop losses in West African nations battling the Ebola virus could lead to as many as one million people going hungry, UN food agencies said on Wednesday. Duration: 00:52 Video provided by AFP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins