Title: High Priority Cochrane Reviews in Wound Prevention and Treatment
Funder: Department of Health (England)

Abstract: Everyone will have wounds during their lifetime. Whilst most wounds are uncomplicated some are more complex by virtue of their size the cause of the wound or underlying co-morbidities. Generally these more complex wounds heal by secondary intention that is from the bottom up. Complex wounds include: skin ulcers due to pressure or underlying disease such as leg ulcers in people with venous insufficiency and foot ulcers in people with diabetes; open surgical wounds and traumatic wounds including burns.Collectively complex wounds are common and they (and their complications) cost health services millions. These complex wounds which can occur unexpectedly e.g. following routine surgery also dramatically impact on patients’ physical and mental health-related quality of life. People with complex wounds say that the most important outcome for them is complete wound healing. Other key outcomes include the prevention of wounds such as pressure ulcers and prevention of wound complications e.g. surgical site infection (SSI). Programme PlanThis Programme will focus on three themes selected on the basis of their high priority for patients and the NHS. We will conduct and update high quality Cochrane systematic reviews using Cochrane methods across the following themes:•Theme 1. The prevention and treatment of pressure ulcers (topics prioritised by the James Lind Alliance Pressure Ulcer Priority Setting Partnership; JLAPUP);•Theme 2. High cost high volume wound care interventions;•Theme 3. The prevention and treatment of SSIs.Within each of the above themes we will also:•Develop apply and evaluate a rapid review process;•Conduct network meta-analyses;•Conduct of overviews of reviews.Planned reviews supported by the PGTheme 1: Prevention and treatment of pressure ulcersThe following were high priority topics generated by the JLAPUP for which there is no relevant Cochrane review (figure in brackets is the JLAPUP ranking for this question):•Involving patients family and lay carers in pressure ulcer prevention for at-risk patients (2nd)•Health professional education and training for pressure ulcer prevention (3rd)•Service delivery models for preventing and treating pressure ulcers (5th)•Bed rest for pressure healing in wheelchair users (7th)•Four reviews on dressings for healing pressure ulcers (8th)•dressings for pressure ulcers (8th) (reviews and a network meta-analysis)•Plastic surgery for pressure ulcers (=10th)Theme 2: High cost high volume wound care interventions•Tests for elevated protease activity in venous leg ulcers (Diagnostic Test Accuracy review)•Effectiveness of a test and treat policy for elevated protease in venous leg ulcers •Antibiotics and antiseptics for pressure ulcers•Antibiotics and antiseptics burns•Antibiotics and antiseptics for open surgical wounds•Negative pressure wound therapy for open surgical wounds•Negative pressure wound therapy for traumatic wounds•Antibiotics and antiseptics for foot ulcers in people with diabetes (update)•Negative pressure wound therapy for pressure ulcers (update)•Negative pressure wound therapy for venous leg ulcers (update)•Synthesis of evidence for competing treatments for pressure ulcers and leg ulcers (network meta-analysis)Theme 3. The prevention and treatment of surgical site infections (SSIs)•Nasal decontamination in S.aureus carriers for prevention of SSI•Diathermy for the prevention of SSI•Perioperative oxygenation for the prevention of SSI•Intra-cavity lavage or wound irrigation for the prevention of SSI•Use of intraoperative topical antiseptics/antimicrobials before wound closure for the prevention of SSIs•The timing of antibiotic provision for the treatment of superficial SSI•Surgical hand antisepsis to reduce SSI (update)•Tissue adhesives for closure of surgical incisions (update)•Prevention of SSI (overview of reviews)


Research activity codes: 7.3 MANAGEMENT AND DECISION MAKING
Health categories: INFECTION;SKIN