Which medical devices and/or local drug should be curatively used, as of 2012, for PU patients? How can granulation and epidermidalization be promoted? Developing French guidelines for clinical practice - 29/10/12
, A.S. Moiziard b, B. Barrois c, P. Ribinik c, D. Colin d, J.M. Michel e, Y. Passadori f
Corresponding author.
Benvenuto su EM|consulte, il riferimento dei professionisti della salute.
Articolo gratuito.
Si connetta per beneficiarne
Abstract |
Introduction |
Management of a patient with pressure ulcer sore(s) must associate local and general treatment.
Objectives |
To determine which medical devices other than supports and which treatments may be used for pressure sore healing (granulation tissue and epithelization/epidermidalization) as of 2012.
Methods |
Systematic review of the literature querying the databases: PASCAL Biomed, PubMed, and Cochrane library from 2000 through 2010.
Results |
Data in the literature on granulation tissue and epithelisation/epidermidalization in pressure sore healing are poor. The level of evidence regarding the relative effectiveness of one modern dressing compared to another has remained low. However, the study data on the interest of hydrocolloid dressing compared with impregnated gases are more significant.
Discussion |
Studies with heterogeneous results and populations have shown low power. Meta-analyses are difficult due to the wide range of therapeutic aims. Further clinical studies with adequate methodology are needed prior to elaboration of more specific recommendations.
Conclusion |
The use of hydrocolloid dressing may be recommended to improve granulation tissue development and epithelization/epidermidalization in pressure sore (Level B).
Il testo completo di questo articolo è disponibile in PDF.Résumé |
Introduction |
La prise en charge d’un patient porteur d’escarre(s) comporte un traitement général associé au traitement local.
Objectifs |
Déterminer quels dispositifs locaux en dehors des supports et quels médicaments utiliser pour assurer le bourgeonnement et la réépidermisation d’une escarre en 2012.
Méthode |
Revue systématique de la littérature avec interrogation des bases de données PASCAL Biomed, PubMed et Cochrane Library entre 2000 et 2010.
Résultats |
Les articles analysés traitent peu spécifiquement du bourgeonnement et de la réépidermisation des escarres. Les données qui permettent de préférer certains types de pansements modernes à d’autres restent d’un faible niveau de preuve. Les études sont en revanche plus significatives sur la comparaison de l’intérêt des hydrocolloïdes par rapport aux gazes imbibées.
Discussion |
Les études sont de faible puissance avec des résultats et des populations hétérogènes et des objectifs différents rendant difficile une méta-analyse. Des travaux cliniques supplémentaires, de qualité méthodologique élevée, sont nécessaires pour élaborer des recommandations plus précises.
Conclusion |
Il y a un intérêt à utiliser les hydrocolloïdes pour favoriser le bourgeonnement et la réépidermisation d’une escarre (Grade B).
Il testo completo di questo articolo è disponibile in PDF.Keywords : Pressure sore, Stage, Local treatment, Device, Dressing, Guidelines, Evidence-based medicine
Mots clés : Escarres, Stade, Traitement local, Pansements, Dispositifs, Guidelines, Médecine fondée sur les preuves
Mappa
Vol 55 - N° 7
P. 489-497 - Ottobre 2012 Ritorno al numero
Articolo precedente
- Which medical device and/or which local treatment for prevention in patients with risk factors of pressure sores in 2012. Towards development of French guideline for clinical practice
- B. Nicolas, A.S. Moiziard, B. Barrois, D. Colin, J.M. Michel, Y. Passadori, P. Ribinik
- Which medical device and/or which local treatment are to be used, as of 2012, in patients with infected pressure sore? Developing French guidelines for clinical practice
- H. Arzt, I. Fromantin, P. Ribinik, B. Barrois, D. Colin, J.-M. Michel, Y. Passadori
Benvenuto su EM|consulte, il riferimento dei professionisti della salute.