Topic Three: Evidence in Wound Care

It is possible to conduct randomised controlled trials (RCT) for wound care products, but it is often challenging to do so. This is because each wound is unique and, therefore, should be treated individually. This makes it harder to find a set of patients with the same characteristics to conduct an RCT. Ideally, for an RCT, the patients and their wounds would all be the same (no variables), and the only variable would be the type of wound care product applied. The upshot of this is that there is very little reliable evidence relating to wound care products. There have been RCTs in venous leg ulcers, Vens-6- York University, with specific randomisation processes that stratify risk factors and wound types/sizes. The challenge is that this process requires a high volume of individuals with the right wounds to achieve strong results.

Such evidence that does exist tends to be either in the form of case studies or clinical evaluations with a small sample size. No wider conclusions can be drawn between studies on the efficacy of one wound dressing over another (Horkan et al., 2009; NICE, 2016).

This lack of scientific evidence is well documented. For example, a report from the National Prescribing Centre included the following statement:

‘There is little high-quality evidence from RCTs or systematic reviews of controlled clinical trials on which to base dressing selection. What evidence there is suggests little difference in efficacy between any of the advanced dressings for healing of chronic wounds’ (National Prescribing Centre, 2010).

Horkan et al. (2009) commented on the need for further research: ‘From an analysis of 13 systematic reviews, it appears that consistent evidence of one moist wound healing dressing is better over another is still lacking.'

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