Review: Studies provide weak evidence for skin ulcer treatments

Researchers found in a systematic review they conducted of papers focused on the treatment of skin ulcers that many studies were technically flawed, yielded unreliable results and provided weak evidence that some of these treatments work better than standard compression therapy or special stockings.

According to a press release from Johns Hopkins Bayview Medical Center in Baltimore, researchers there identified 66 papers among 10,066 citations related to wound care that specifically addressed the effectiveness of treatments for chronic venous leg ulcers.

When they analyzed clinical outcomes for wound dressings, antibiotics and venous surgery, the investigators found the overall results showed that wound healing increased when patients wore dressings that used living human cells.

These results suggested that cadexomer iodine and collagen may also increase healing, Gerald Lazarus, MD, founder of the Johns Hopkins Wound Healing Center at Johns Hopkins Bayview Medical Center, noted in the release.

Lazarus and colleagues found the evidence in favor of systemic antibiotic use was inconclusive unless demonstrated signs of infection were present and surgical treatment, such as radiofrequency ablation, endovenous laser treatment and sclerotherapy, also proved inconclusive for supporting healing. However, the results showed that surgical correction of underlying pathology helped decrease ulcer recurrence.

“There is a critical need for well-designed research studies to compare the current minimally invasive surgical interventions to the gold standard of care, compression therapy,” Lazarus, who is also professor of dermatology and medicine at Johns Hopkins Bayview Medical Center, stated in the release.

“The review should serve as a means to bring the wound healing community together to improve the situation,” he stated.

Disclosure: This research was funded by the Agency for Healthcare Research and Quality.

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