An Evaluation of the Association for the Advancement of Wound Care Venous Ulcer Guideline and Recommendations for Further Research

Morton, Laurel M.; Bolton, Laura; Corbett, Lisa Q.; Girolami, Susan; Phillips, Tania J.

doi:10.1097/01.asw.0000434057.81199.6c

Cited by 4 publications

(3 citation statements)

References 55 publications

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“…In cases of deep infections, systemic treatment is indicated. 18,27,[40][41][42]44,45,49 When the exudate drained from the wound is elevated, exceeding the absorption capacity of the covering, it can generate aggressions to the perilesional tissue such as maceration, which is often accompanied by pain. It is advisable to adopt a high absorption covering or that allows the transfer of the exudate to a second covering, such as foams dressing, alginates, and hydrofibers.…”

Section: Description Of Interventionsmentioning

confidence: 99%

Scientific Evidence on Interventions for Palliative Care Patients With Wound: A Scoping Review

Lucena

Costa

Pereira

et al. 2020

R.pesq.:cuid.fundam.Online

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Objetivo: Mapear as evidências científicas sobre intervenções direcionadas a pessoas com feridas em cuidados paliativos. Método: Revisão de Escopo realizada com estudos em português, inglês e espanhol, provenientes de bases de dados nacionais e internacionais, publicados no período de 2010 a 2019. Resultados: Foram incluídas 41 publicações oriundas de 14 nacionalidades. Os estudos apresentam como principal temática a avaliação e tratamento de feridas de diferentes etiologias. As intervenções foram apresentadas em relação aos aspectos da gestão do cuidado, etapas básicas do cuidado da ferida, aspectos psicossociais e espirituais. Conclusão: É necessária uma avaliação criteriosa do paciente e da ferida. Caso os parâmetros sejam favoráveis à cicatrização, a equipe adotará a terapêutica específica para alcançá-la. Caso contrário, o cuidado deverá incluir realização de técnicas mais conservadoras e menos invasivas, manejo de sinais e sintomas, além de intervenções voltadas aos impactos sociais, psicológicos e espirituais relacionados à ferida.

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Section: Description Of Interventionsmentioning

confidence: 99%

Scientific Evidence on Interventions for Palliative Care Patients With Wound: A Scoping Review

Lucena

Costa

Pereira

et al. 2020

R.pesq.:cuid.fundam.Online

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“…Shaneyfelt and Centor [13] evaluated the strength of evidence in cardiology clinical practice guidelines and found 48% of the guidelines were based on low-quality evidence. Similar studies in dermatologic oncology [3], comorbidities in chronic conditions [14], orthopedic surgery [15], fibromyalgia [16], pediatric obesity [17], and wound care [18] have all demonstrated a need for improvement in the strength of evidence for clinical practice guidelines. In this study, we evaluate the strength of the evidence supporting the recommendations constituting the American Academy of Dermatology clinical practice guidelines.…”

Section: Introductionmentioning

confidence: 98%

Evaluation of the Level of Evidence Supporting the Recommendations Constituting the American Academy of Dermatology Clinical Practice Guidelines: Cross-Sectional Analysis

Courtney¹

2020

JMIR Dermatol

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Background Clinical practice guidelines are evidence-based recommendations used by physicians to improve patient care. These guidelines provide the physician with an assessment of the benefits and harms of a treatment and its alternatives. Therefore, it is essential that the clinical practice guidelines be based on the strongest available evidence. Numerous studies in a variety of different fields of medicine have demonstrated that recommendations supported by weak evidence are a common theme in clinical practice guidelines. A clinical guideline based solely on weak evidence has the capability to reduce the quality of care provided by physicians. Objective Our primary objective is to evaluate the levels of evidence supporting the recommendations constituting the American Academy of Dermatology clinical practice guidelines. Methods Using a cross-sectional study design, authors SM and RO located all current clinical practice guidelines on the American Academy of Dermatology website on June 10, 2017, and December 11, 2019. Each recommendation and its corresponding evidence rating were extracted in a duplicate and blinded fashion. A consensus meeting was planned a priori to resolve disagreements in extractions or stratifications. Results In total, 6 clinical guidelines and their subsections were screened and 899 recommendations were identified. Our final data set included 841 recommendations, as 58 recommendations contained no level of evidence and were excluded from calculations. Many recommendations were supported by a moderate level of evidence and therefore received a B rating (346/841, 41.1%). Roughly one-third of the recommendations were supported by a strong level of evidence and were given an A rating (n=307, 36.5%). The clinical practice guideline with the highest overall strength of evidence was regarding the treatment of acne, which had 17 of 35 (48.6%) recommendations supported by strong evidence and only 2 (5.7%) supported by weak evidence. The clinical practice guideline with the fewest recommendations supported by strong evidence was melanoma (13/63, 20.6%). Conclusions Clinical practice guidelines that lack strong supporting evidence could negatively affect patient care, and dermatologists should be mindful that not all recommendations are supported by the strongest level of evidence. An increased quantity of quality research needs to be performed in the field of dermatology to improve the evidence supporting the American Academy of Dermatology clinical practice guidelines.

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“…12,13 Moreover, different clinical guidelines lack consensus regarding the recommended interventions. 14,15 This makes pursuit of new modalities for CVUs management a vital clinical and economic priority.…”

mentioning

confidence: 99%

A New Powder Dressing for Management of Chronic Venous Ulcers

et al. 2023

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BACKGROUNDA new powder dressing (TPD) is a methacrylate-based powder formulation that transforms in situ into a shape-retentive matrix upon hydration to create optimum moist wound healing conditions. The following randomized, controlled, clinical study aimed to evaluate the role of TPD in the management of chronic venous ulcers (CVU).METHODSThe randomized controlled prospective study enrolled 60 CVU patients. After randomization, patients in the treatment group (n = 30) were treated with TPD, whereas those in the control group (n = 30) received conventional compression dressing therapy.RESULTSAfter treatment, patients in the TPD group had significantly higher rates of complete ulcer healing at 12 weeks (43.3% vs 10.0%, p = .004) and 24 weeks (86.7% vs 40.0%, p = .001) when compared with conventional dressing group. Moreover, patients in the TP dressing group had significantly shorter time to complete ulcer healing [mean (95% CI): 16.7 (14.1–19.3) versus 37.0 (30.8–43.2) weeks, p = .001]. In addition, patients in the TPD group had significantly fewer number of dressings, less severe pain after dressing, and lower need for systemic analgesics.CONCLUSIONUse of TPD in management of CVUs was associated with significantly higher healing rates, shorter duration to healing, and lower pain.

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An Evaluation of the Association for the Advancement of Wound Care Venous Ulcer Guideline and Recommendations for Further Research

Abstract: Better evidence for recommendations with less than A-level support may improve the quality and consistency of VU care, reduce costs, and improve resource use.

Cited by 4 publications

References 55 publications

Scientific Evidence on Interventions for Palliative Care Patients With Wound: A Scoping Review

Scientific Evidence on Interventions for Palliative Care Patients With Wound: A Scoping Review

Evaluation of the Level of Evidence Supporting the Recommendations Constituting the American Academy of Dermatology Clinical Practice Guidelines: Cross-Sectional Analysis

A New Powder Dressing for Management of Chronic Venous Ulcers

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