The need to improve

Abstract

B y now, many of you will already be aware of the systematic review released by a group of researchers from the John Hopkins Evidence-Based Practice Centre and the John Hopkins Wound Healing Centre. A total of 60 research papers focused on the efficacy of various treatments for chronic venous leg ulcers were evaluated, and found to consist of so many methodological faults that any results derived from the studies were deemed unreliable. For busy wound clinicians who may not have time to scour through the literature looking for the most up-to-date and effective treatment options, such systematic reviews are fundamental. This review, however, has inadvertently lead to further confusion and scepticism about the accuracy and reliability of wound care research. The treatment of chronic skin wounds related to poor circulation costs the US approximately $25 billion per year, while in the UK, venous leg ulcers have been estimated to cost the NHS £400 million a year. It is safe to say that funding for wound care research has not been growing in parallel with the burden that chronic wounds are imposing on individuals worldwide. The prevalence of chronic ulcers will indisputably increase along with the growing epidemic of diabetes and obesity. While the effective practice of wound care on patients in the hospital and clinic must improve, it is even more important that the reporting of these practices is bettered. Large, developing nations like India and China, where chronic diseases like diabetes has reached epidemic proportions, look up to the advances in wound care research in developed countries like the UK and the US. The finding from the review that only very weak evidence exists to prove that certain treatments (such as advanced wound dressings or venous surgery) are better than traditional compression therapy or specialised stockings is not an indication that these novel interventions do not work in improving wound healing; it simply implies that there remains a need for welldesigned research studies that can prove that these novel dressings are superior to the current gold standard treatment. In other news, this month’s issue of JWC features a special supplement in collaboration with the Academy of Physicians in Wound Healing (APWH). This will be the first supplement of four to be published this year. This month’s issue also features our cases supplement, the first of three this year, so there is a great variety of articles for you to enjoy. Happy reading!