Effects and associations of nutrition in patients with venous leg ulcers: A systematic review

Barber, G.A.; Weller, Carolina; Gibson, Simone

doi:10.1111/jan.13474

Cited by 47 publications

(61 citation statements)

References 68 publications

(280 reference statements)

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“…Three SRs related to weight management were published, including one on nutritional status and supplements and two on exercising . The authors reported that increased body mass index was associated with delayed wound healing, but the evidence of effectiveness of weight management in improving VLU healing is lacking . However, micronutrients, including vitamin D and folic acid, may improve wound healing in at‐risk patients .…”

Section: Resultsmentioning

confidence: 99%

“…The authors reported that increased body mass index was associated with delayed wound healing, but the evidence of effectiveness of weight management in improving VLU healing is lacking . However, micronutrients, including vitamin D and folic acid, may improve wound healing in at‐risk patients . An SR assessing the effectiveness of the oral nutritional supplements in VLU management is in progress .…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Adjuvant therapies in venous leg ulcer management: A scoping review

Team

Chandler

Weller

2019

Wound Repair Regeneration

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Compression therapy is the current evidence-based approach to manage venous leg ulcers (VLU); however, adherence is a major barrier to successful treatment. Combination approaches may relieve the burden of treatment by shortening the time to ulcer healing. This scoping review conducted by Australian researchers aimed to establish the evidence of effectiveness of various adjuvant methods on wound healing and recurrence. Randomized Controlled Trials (RCTs), and Systematic Reviews (SR) and Meta-Analyses (MA) on VLU management approaches published from January 2015 to December 2018 were included in this review. The articles included in the scoping review were grouped according to the management approaches, including (1) pharmaceutical interventions, (2) surgical interventions, (3) topical agents, (4) the use of devices, and (5) other, such as physiotherapy and psychological interventions. Results of this scoping review indicate that there is a limited high-quality evidence of effectiveness in most adjuvant therapies on wound healing and recurrence. Given the lowquality evidence observed in this scoping review for adjuvant treatments, the implication for practice is that current management guidelines be followed. Further rigorous studies have the potential to produce better quality evidence. Quality of evidence can be improved by ensuring large sample sizes of a single etiology wounds, standardizing reporting outcomes, and maintaining detailed and evidence-based protocols in physiological or psychological interventions.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Adjuvant therapies in venous leg ulcer management: A scoping review

Team

Chandler

Weller

2019

Wound Repair Regeneration

Self Cite

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“…Excess weight and obesity are established independent risk factors for venous ulceration and are associated with delayed VLU healing, yet only 76 studies (just over half of our sample) reported on the BMI of their included patients. The prevalence of obesity (BMI >30) among people with VLU is gaining more attention with one study ( N = 1,163 patients) reporting that 33% had a BMI >30 and a further study reporting 60% of people with VLU being either overweight or obese .…”

Section: Discussionmentioning

confidence: 99%

External validity of randomized controlled trials of interventions in venous leg ulceration: A systematic review

Gethin

Ivory

Connell

et al. 2019

Wound Repair Regeneration

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We set out to evaluate quality of reporting of data related to external validity from randomized controlled trials (RCTs) assessing treatment interventions for active venous leg ulcers. Using a systematic review study design, we identified 144 full‐text RCTs of treatment interventions, where the wound was assessed and published in English from 1998 to 2018. We found that the median study sample size was 75.5. Weighted mean wound size was 13.22 cm2 and weighted mean wound duration was 22.20 months. Forty‐six (32%) reported numbers screened for eligibility and 27 (19%) reported the number who declined to participate; 19 (13%) reported on patient ethnicity; 60 (42%) reported comorbidities; and 5 (4%) reported current medication use. When reported, 60/102 (59%) excluded patients with an ankle‐brachial pressure index <0.8; 68/135 (50%) were conducted in Europe, 6/135 (4%) in Asia, and 74/104 (71%) were conducted in outpatient facilities; 3 (2%) reported socioeconomic factors and 88 (61%) reported on adverse events. We concluded that there is inadequate reporting of data related to external validity in reports of RCTs assessing venous leg ulcers treatment interventions. Significant variability exists in the ankle‐brachial pressure index cutoff point for inclusion or exclusion, making generalizability difficult to assess.

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“…Encourage activities that promote good skin care and hygiene, reduction of leg oedema, good nutrition, obesity reduction, and improvement in general health and wellbeing 28293031. Exercise is safe, and it reverses the effects of venous hypertension but does not promote ulcer healing per se 282932…”

Section: How To Treat Venous Leg Ulcers?mentioning

confidence: 99%