The Contribution of the Commercial Sector to Tissue Viability

Abstract

Tissue viability is typically presented as an area of health care which best achieves successful results through multi professional collaboration. The contributions of the different academic and clinical professional groups, and of their constituent specialities, to tissue viability, are beginning to be stated explicitly 1 • 2 • 3 • This article presents a strictly personal view of the contribution of the commercial sector to tissue viability. Clearly I cannot claim to represent each of the thousands of individuals who work to develop and offer new technologies to assist wound healing. Perhaps, for many, the contribution of the commercial sector begins, and ends, with the availability of products. The past decade has witnessed the rapid growth of new products with each promoted as an effective solution to differing tissue viability problems. While the increased range of interventions is an obvious contribution of the commercial sector to the field of tissue viability, the value of many of these new technologies is open to question. For example, while at least 200 different forms of pressure-redistributing mattress are commercially available, only 30 randomised controlled trials comparing the efficacy of such devices are available in the literature 4 with the majority of these investigations reported to exhibit significant methodological flaws. The provision of data to support claims of efficacy is a key responsibility of the commercial sector. Given this responsibility manufacturers, through their funding of investigations, can make a strong contribution to the development of the evidence base which underpins tissue viability. However, for such a contribution to be fully achieved, the credibility of commercially funded research must be enhanced. Bero and Rennie 5 recently reviewed the quality of published studies which had been funded by the pharmaceutical industry. This review highlighted that these publications were often seriously flawed, with three key weaknesses noted; negative results were frequently not published, the funder controlled the content of the publication with articles published without peer-review. Research into wound prevention and healing, which frequently derives its funding from product manufacturers, will continue to be viewed with caution unless the tissue viability community works together to enhance the credibility of studies funded by industry. Bero and Rennie 5 offered a number of initiatives which would improve the credibility of industry funded research. Fundamental to this process was the recommendation that 'companies commit themselves to submitting for publication every study that is undertaken, regardless of the findings'. This commitment to publication could, according to Bero and Rennie, be monitored through the implementation of a register of new studies. Perhaps the development and maintenance of such a register could be one future activity for the Tissue Viability Society? The commercial sector has a major role to play in the generation of new evidence but this contribution will flower best when industry, researchers, and journal editors take responsibility for the quality of studies that are published 5 •