Clinical research on the use of bordered foam dressings in thetreatment of complex wounds: a systematic review of reportedoutcomes and applied measurement instruments
Journal of Tissue Viability 2022 https://doi.org/10.1016/j.jtv.2022.05.005
Raepsaet, C., Alves, P., Cullen, B., Gefen, A., Lazaro-Martinez, J.L., Lev-Tov, H., Najafi, B., Santamaria, N., Sharpe, A., Swanson, T., Woo, K., Beeckman, D.
Introduction
- Bordered foam dressings have become increasingly popular in the treatment of complex wounds because of their specific features.
- Despite the popularity of bordered foam dressings, it is unclear which outcomes are being measured to evaluate their effectiveness and how these are measured across research centres and groups.
Aims
- To identify reported outcomes and measurement instruments used in clinical research on bordered foam dressings in the treatment of complex wounds.
Methods
- MEDLINE (PubMed interface), Cumulative Index to Nursing and Allied Health Literature (CINAHL), EMBASE, and The Cochrane Library were systematically searched using a combination of key terms including: wounds, bordered foam dressings, and treatment.
- Studies were included if they (i) targeted an adult population; (ii) addressed the treatment of complex wounds with a bordered foam dressing as the primary wound dressing; (iii) were retrieved from original research; and (iv) were published between 2000 and 2022.
- There were no restrictions on language or study design.
- Studies that focused primarily on the prevention of complex wounds were excluded.
- Data extraction included outcome domains, outcomes, instruments, time points, and outcome measures.
- The OMERACT Filter 2.0 was used as a conceptual framework for the extraction of outcomes
Results
- Twenty four outcome domains and 82 outcomes were identified.
- The outcomes were categorised into five core areas: (i) impact on life; (ii) dressing performance; (iii) pathophysiological manifestations; (iv) resource use; and (v) adverse events.
- Thirty nine outcomes (47.0%) were measured at more than one time point.
- The most frequently reported time point was ‘at the end of treatment’ (62.7%).
- Outcomes were measured using self-report instruments, clinical observations, and bio-physiological instruments.
Category: Impact on life
|
Outcome domain |
Outcomes |
| Pain | Local wound pain; pain on removal/change dressing |
| Self-management | Patient/family involvement; ease of dressing application; ease of dressing removal |
| Dressing comfort | Comfort during wear; overall impression; exudate management; conformability on application; conformability before removal; dressing bulkiness; friction; discrete appearance; allowance of normality of daily routines; stay-on ability; stick to hairy skin; durability during showering; fluid lock capability; dressing adherence; odour control |
| Skin condition | Wound progress; condition of surrounding skin; wound protection |
| Quality of life | Overall quality of life during treatment; confidence |
Example of a category and associated outcome domains and outcomes
Conclusions
- The systematic review identified reported outcomes and measurement instruments in research on bordered foam dressings in the treatment of complex wounds.
- The variety and lack of consistency in terms of instruments, time points and outcome measurements made it difficult to compare data directly across different reported studies.
- A solution to the variety in outcome reporting across studies in complex wound care, and moreover for the treatment with bordered foam dressings, is the development of a Core Outcome Set (COS).
- The outcomes in this review article will inform the next steps of developing a COS, where patients, clinicians and researchers will be involved to decide on the final outcomes included in a COS for the treatment of complex wounds with bordered form dressings.
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