COCHRANE REVIEWS fit people at risk of developing pressure ulcers. REVIEW UPDATE: publication in The Cochrane What are pressure ulcers? Library, 2022, Issue 4 Pressure ulcers are injuries to the skin and underlying tis- sue that can be caused by prolonged pressure. Sitting can be an important part of a person’s recovery process, but sitting for long periods can increase the risk of develop- ing pressure ulcers. Negative pressure wound therapy for surgical wounds healing by primary closure How are pressure ulcers managed? Specialist cushions and surfaces aim to redistribute pres- Gill Norman, Chunhu Shi, En Lin Goh, Elizabeth MA sure on the skin when people have to stay sitting for long Murphy, Adam Reid, Laura Chiverton, Monica Stankie- periods of time. There has been more research into the wicz, Jo C Dumville effects of using pressure redistributing cushions in wheel- chairs than in standard chairs. Citation: Norman G, Shi C, Goh EL, Murphy EMA, Reid A, Chiverton L, Stankiewicz M, Dumville JC. Neg- We do not currently know how effective pressure redis- ative pressure wound therapy for surgical wounds healing tributing static chairs are, compared with standard by primary closure chairs, for preventing or managing pressure ulcers in at- risk people. Cochrane Database of Systematic Reviews 2022, Issue 4. Art. No.: CD009261. Pressure redistributing static chairs range from standard hospital chairs and chairs used in residential settings with DOI: 10.1002/14651858.CD009261.pub7 no cushion or manual/dynamic function, to those with integrated pressure redistributing surfaces and recline, ABSTRACT rise or tilt function when the person is sitting in it. These Background can be produced to a standard design or a bespoke Indications for the use of negative pressure wound ther- design tailored to the needs of the person. apy (NPWT) are broad and include prophylaxis for sur- gical site infections (SSIs). Existing evidence for the What did we want to find out? effectiveness of NPWT on postoperative wounds healing We wanted to find out how effective pressure redistribut- by primary closure remains uncertain. ing static chairs are for preventing or managing pressure ulcers in health, rehabilitation and social care settings, Objectives and residential places where people may spend their day. To assess the effects of NPWT for preventing SSI in wounds healing through primary closure, and to assess What did we do? the cost‐effectiveness of NPWT in wounds healing We searched for published and unpublished studies that through primary closure. assessed pressure redistributing static chairs for prevent- - ing or managing pressure ulcers. There were no restric- Search methods tions on language, date of publication or study setting. In January 2021, we searched the Cochrane Wounds Specialised Register; the Cochrane Central Register of What did we find? Controlled Trials (CENTRAL); Ovid MEDLINE We did not find any eligible completed or registered (including In-Process & Other Non-Indexed Citations); studies investigating the effects of pressure redistributing Ovid Embase and EBSCO CINAHL Plus. We also static chairs for preventing or managing pressure ulcers. searched clinical trials registries and references of included studies, systematic reviews and health technol- There is no current high-quality evidence that supports ogy reports. There were no restrictions on language, pub- or refutes the role of pressure redistributing static chairs lication date or study setting. for preventing or managing pressure ulcers. Selection criteria This is a priority area and there is a need to explore this We included trials if they allocated participants to treat- intervention with rigorous and robust research. ment randomly and compared NPWT with any other type of wound dressing, or compared one type of How up to date is this evidence? NPWT with another. This evidence in this Cochrane Review is up to date to June 2021. Data collection and analysis At least two review authors independently assessed trials using predetermined inclusion criteria. We carried out data extraction, assessment using the Cochrane risk of 131 JOURNAL OF WOUND MANAGEMENT OFFICIAL JOURNAL OF THE EUROPEAN WOUND MANAGEMENT ASSOCIATION
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