Electrical stimulation vs. standard care for chronic ulcer healing: a systematic review and meta‐analysis of randomised controlled trials

Barnes, Rachel; Shahin, Yousef; Gohil, Risha; Chetter, Ian

doi:10.1111/eci.12244

Cited by 53 publications

(55 citation statements)

References 48 publications

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“…Publication bias was seldom addressed in these SRs; only one review provided a funnel plot. 105 This is not surprising since it is a relatively new concept in this field. 117 In most instances, studies with low total PRISMA scores and also included less than 50% of available studies published during the time frame were included in the review (Table 4).…”

Section: Discussionmentioning

confidence: 98%

“…94,[97][98][99][101][102][103] Critical appraisal of SRs and meta-analyses Table 4 outlines the details of 18 reviews that have been published in the literature on the effect of EST on wound healing. 5,10,14,15,[104][105][106][107][108][109][110][111][112][113][114][115][116] Eight of the reviews completed at least some form of meta-analysis. 10,15,[104][105][106][107][108][109] Three other reports stated that although a meta-analysis was planned, none was done because of heterogeneity of included studies.…”

Section: Narrative Reviewsmentioning

confidence: 99%

“…5,10,14,15,[104][105][106][107][108][109][110][111][112][113][114][115][116] Eight of the reviews completed at least some form of meta-analysis. 10,15,[104][105][106][107][108][109] Three other reports stated that although a meta-analysis was planned, none was done because of heterogeneity of included studies. 14,112,113 The first SR published on this topic was produced by Gardner et al in 1999, and impressively, it also included a meta-analysis.…”

Section: Narrative Reviewsmentioning

confidence: 99%

“…109 The results of eleven of the 18 included SRs favored the use of EST in the treatment of various types of chronic wou nds. 5,10,102,104,105,[107][108][109][110][111]116 The authors' concluding statements regarding EST use in wound treatments obtained from each review are presented in Table 4. In four reviews, the authors' recommendations suggested that there was no evidence to support routine clinical use of EST for wound therapy.…”

Section: Narrative Reviewsmentioning

confidence: 99%

“…Even when the inclusion criteria set out by the review were considered, only eleven of 18 published SRs considered the majority (>50%) of clinical trial studies available in the published literature. 5,10,102,[105][106][107][108][109][110]115,116 In some instances, the inclusion of a relatively low proportion of available studies was explained by the authors' decision to only examine clinical reports published during certain years. Without explanation, two SRs 14,112 chose not to include any clinical research published before the year 2000 which unfortunately resulted in the exclusion of 18 of possible 33 CTs.…”

Section: Narrative Reviewsmentioning

confidence: 99%

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Electrical stimulation therapy to promote healing of chronic wounds: a review of reviews

Houghton¹

2017

CWCMR

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Purpose:The overall objective of this study is to identify and appraise all of the existing clinical research literature that has evaluated the effect of electrical stimulation therapy (EST) on wound healing outcomes in adults with various types of chronic wounds. Methods: A systematic and comprehensive search of four electronic databases and gray literature was carried out, and references included in related review articles were checked. Prospective and controlled clinical trials, systematic reviews (SRs), and meta-analyses that assessed the effects of EST on wound healing outcomes were described and appraised. A total PRISMA score was assigned for each included SR based on criteria included in the assessment of multiple systematic reviews (AMSTAR) measurement tool. The percentage of available research that was identified in the SR was also calculated. Results: Sixty-two clinical research studies involving 2082 patients with pressure ulcers, venous leg ulcers, diabetic foot wounds, and arterial/ischemic wounds, and ulcers of mixed etiology were located. Thirty-three of the studies with 1370 patients compared wound size reduction after EST to a control group. Eighteen reviews that used a systematic approach to identify, select, and evaluate published studies on this topic have yielded conflicting results. Poorer quality SRs with a low total PRISMA score were more likely to yield negative or inconclusive findings. Most of these low-quality SRs had very vague research questions and included less than 50% of the available literature that was known to exist. Results from 22 well-designed randomized clinical trials and 10 high-quality SRs consistently support that EST can stimulate faster wound size reduction and/or produce a greater number of closed wounds compared to a group of similar patients receiving either standard wound care or sham EST. Conclusion: Pooled results from well-conducted SRs provide strong support for the use of EST on various types of chronic wounds and pressure ulcers in particular.

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Section: Discussionmentioning

confidence: 98%