The Wound Healing Society guidelines for the treatment of arterial insufficiency ulcers were originally published in 2006. These guidelines provided recommendations, along with their respective levels of evidence on seven categories: diagnosis, surgery, infection control, wound bed preparation, dressings, adjuvant therapy, and long-term maintenance. Over the last 7 years, a great deal of literature regarding these aspects of arterial ulcer management has been published. An advisory panel comprised of academicians, clinicians, and researchers was chosen to update the 2006 guidelines. Members included vascular surgeons, internists, plastic surgeons, anesthesiologists, emergency medicine physicians, and registered nurses, all with expertise in wound healing. The goal of this article is to evaluate relevant new findings, upon which an updated version of the guidelines will be based.
METHODS
Data sources and searchesWe sought to capture the highest quality of literature available regarding arterial insufficiency ulcer diagnosis and treatment using a key word search of PubMed, Embase, and Cochrane Library databases. Similarly, the citations of relevant articles were examined by hand. Key terms were generated from the existing guidelines. The search was limited to meta-analyses, systematic reviews, randomized controlled trials (RCTs), retrospective series reviews, clinical case series, and expert panel recommendations published between January 2006 and 2013. It was further limited to only English publications, and review articles and case reports were excluded.The findings of these articles have been divided into one or more of the appropriate categories (diagnosis, surgery, infection control, wound bed preparation, dressings, adjuvant therapy, and long-term maintenance) as performed in the original guideline.