Wound infection, dressings and pain, is there a relationship in the chronic wound?

Cutting, Keith; White, Richard; Mahoney, Paul

doi:10.1111/j.1742-481x.2012.00947.x

Cited by 19 publications

(22 citation statements)

References 48 publications

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“…There was one systematic review—level I evidence which compared the value in identifying pathogens between wound swab and wound biopsy techniques. Six expert opinion or consensus documents, which focused on diagnosis of infection in chronic wounds and/or CLUs were also included . Of the remaining 73 articles, eleven focused on clinical signs and symptoms of infection in chronic wounds, 12 focused on diagnosis of infection, and 50 examined the effectiveness of numerous treatment methods for chronic wound infection.…”

Section: Resultsmentioning

confidence: 99%

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The diagnosis of infection in chronic leg ulcers: A narrative review on clinical practice

Bui

Finlayson

Edwards

2019

International Wound Journal

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This literature review aimed to provide a narrative review of evidence on validity of clinical and microbial indicators of infection and to gain insights into the diagnosis of infection in chronic leg ulcers (CLUs). A search was conducted in Cinahl, Medline, the Cochrane Library databases, Embase, Web of Science, ScienceDirect, Pubmed, PsycINFO, ProQuest dissertations, and Google Scholar from January 1990 to July 2017. The inclusion criteria were original studies, systematic reviews, and consensus documents focused on “infection” in CLUs, English language, clinical and community settings, and human. The reviewed studies were inconsistent in criteria for infection between investigated wound types and lack of specificity regarding wound types. There were few studies investigating the criteria for diagnosis of infection in leg ulcers. The identification of leg ulcer infection still remains problematic and relies on out‐of‐date and not uniform evidence. Literature in this area was mostly limited to level III and IV evidence based on The Australian National Health and Medical Research Council Levels of Evidence, or expert opinion. This literature review showed seven clinical signs and symptoms that could be diagnostic for infection in CLUs, including: new, increased, or altered ulcer pain; malodour; increased ulcer area; wound breakdown, delayed or non‐healing; and erythema and increased local temperature, whilst the microbial indicators used to diagnose infected leg ulcers were varied and regarded as less important.

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Section: Resultsmentioning

confidence: 99%

“…Four studies (two cross‐sectional studies, one Delphi study and one case study) concluded increasing pain was diagnostic of chronic wound infection. It is essential to differentiate between pain related to infection and pain related to venous hypertension or other causes.…”

Section: Resultsmentioning

confidence: 99%

The diagnosis of infection in chronic leg ulcers: A narrative review on clinical practice

Bui

Finlayson

Edwards

2019

International Wound Journal

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“…We identified the most frequent eight outcome domains that were included in 25% or more of the included protocols, leaving the majority of outcome domains ( n = 118) being used relatively infrequently. While complete wound healing has been recommended as the most important clinically relevant outcome in many cases, there frequently is focus on the surrogate or interim outcome of changes in wound size . Other important outcomes include wound infection, which can be captured in several different ways, such as pain and quality of life …”

Section: Discussionmentioning

confidence: 99%

“…This finding echoed that of Saldanha et al, where primary outcomes were the most well specified. However, there are objective definitions of healing available; for example, a large RCT of a leg ulcer intervention defined healing of venous leg ulcer as “complete epithelial cover in the absence of a scab (eschar) with no dressing required.” The Food and Drug Administration (FDA) defines complete wound closure as “skin reepithelialisation without drainage or dressing requirements, confirmed at two consecutive study visits two weeks apart, and the time should be specified when being analyzed.” None of the review protocols we examined used these or similar definitions of wound healing. Secondary outcomes such as pain, quality of life, and cost were generally the least‐well specified elements.…”

Section: Discussionmentioning

confidence: 99%

Outcomes in Cochrane systematic reviews related to wound care: An investigation into prespecification

Liu

Saldanha

Margolis

et al. 2017

Wound Repair Regeneration

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The choice of outcomes in systematic reviews about the effects of interventions is crucial, and dictates which data are included and analysed. Full pre-specification of outcomes is also recognised as mandatory in conducting trails to minimise the risk of outcome reporting bias.This study analyses the nature and specification of outcomes used in Cochrane Wounds (CW) systematic reviews. We identified all CW review titles associated with a protocol that was published on or before 1 October 2014 and then categorised all outcome domains and recorded whether they were primary or secondary outcomes. We then identified outcome domains used in 25% or more of the protocols, and examined their specification. Adequacy of outcome specification was assessed for five elements: outcome domain, specific measurement, specific metric used, method of aggregation, and time-points. We included 106 protocols and 126 outcome domains; 24.6% (31/126) were used as primary outcomes.Eight were used in ≥ 25% of protocols: wound healing, quality of life, costs, adverse events, resource use, pain, wound infection, and mortality. Wound healing was the most completely specified outcome domain (median number of elements specified=3; interquartile range[IQR] =1-5) along with resource use (median 3; IQR 2-4). Quality of life (median 1; IQR 1-3); pain (median 1; IQR 1-3); and costs (median 1; IQR 1-4) were the least completely specified outcome domains. Outcomes are frequently poorly pre-specified in the protocols for CW reviews. The elements of metric, aggregation and time-point are rarely adequately specified. We strongly recommend that reviewers make greater efforts to specify outcomes, using the five elements. Better pre-specification of outcomes is likely to improve review quality by reducing risk of bias in data abstraction and analysis and by reducing subjectivity in the decision-making regarding which outcomes to extract; it may also improve outcome specification in clinical trial design and reporting.

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“…13 As well as impairing wound healing, clinical infection may increase the severity of wound-related pain 14,15 and have a direct effect on patient comfort. Indeed, Cutting et al 16 reported on a multinational, multidisciplinary Delphi study that revealed a causal relationship between wound infection and the onset or change in the nature of pain: 15/21 respondents identified this as an issue in event-related pain and 19/21 cited this phenomenon in somatic-related pain, with 17/21 respondents citing that patients with wound infection generally experienced more pain than those who were free of infection. In addition, 20/21 clinicians thought that some types of dressing caused pain during dressing change.…”

Section: Antimicrobial Therapymentioning

confidence: 99%

Silver-containing foam dressings with Safetac: a review of the scientific and clinical data

Davies

McCarty

Hamberg³

2017

J Wound Care

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Phil Davies has more than 25 years of experience of working in healthcare-related industries. During that time, he has authored and contributed to numerous peer-reviewed journal articles and conference presentations (oral and poster) relating to wound care and other areas of healthcare. Phil was awarded a BSc (Hons) Medical Cell Biology and Biochemistry by the University of Liverpool (United Kingdom) in 1989.Sara McCarty was awarded her BSc (Hons) in biomedical sciences in 2008 by the University of Chester, UK. Since then, Sara has gained research experience in the field of wound healing. As a medical writer, she has also authored and contributed to a number of peer-reviewed journal articles and conference presentations. In 2014, she was awarded a PhD in the role and control of matrix metalloproteases in cutaneous wound healing.Kristina Hamberg has over 10 years of experience of working with the design and development of wound care products, particularly those with antimicrobial properties. During that time, she has become an expert within the areas of microbiology and test method development, as well as infection prevention. Kristina was awarded her MSc in food science in 1997 from the University of Kalmar, Sweden, and in 2002 she was awarded a PhD for microbiological evaluation of novel technologies for food preservation by Chalmers Technical University, Gothenburg, Sweden.How to cite this document: Davies, P., McCarty, S., Hamberg, K. Silver-containing foam dressings with Safetac: a review of the scientific and clinical data. J Wound Care 2017; 26: 6 (Suppl. 1), S1-S32. Conclusion S24 References S27Downloaded from magonlinelibrary.com by 054

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Wound infection, dressings and pain, is there a relationship in the chronic wound?

Cited by 19 publications

References 48 publications

The diagnosis of infection in chronic leg ulcers: A narrative review on clinical practice

The diagnosis of infection in chronic leg ulcers: A narrative review on clinical practice

Outcomes in Cochrane systematic reviews related to wound care: An investigation into prespecification

Silver-containing foam dressings with Safetac: a review of the scientific and clinical data

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