The Evidence Base of Adjuvant Wound Healing Used in Human Medicine

Introduction
News in materials, procedures and technologies are increasingly coming from research in the area of wound healing. Before implementation in daily clinical life effectiveness of the procedures or products should be determined. The accepted way to assess effectiveness and quality in health care is evidence-based practice (EBP), which is focusing on the use of current best evidence in making decisions about care of individual patients.

Objective and Methods
Producing evidence based research, which can be accepted by best available external clinical evidence based on randomised controlled trials (RCTs), and meta-analyses of several RCTs.

Results
Recent systematic reviews have shown that a large numbers of procedures, methods, materials and technologies used in wound management are not evidence based. The reasons are inadequate sample size, short follow up, non-random allocation to treatment arms, non-blinded assessment of outcomes, poor description of control and concurrent intervention etc.

Lacking of evidence is clinically producing the following problems: 1. Reimbursement strategies, at least in Europe, are often based on evidence of the used products; 2. Evidence and Cost-effectiveness is the main reason for using a product and 3. The high quality wound research and development may not be performed. A consequence may be that traditional products like gauze and other dry wound healing dressings may be used instead of modern products, which reduces the quality of life of the patients.

In this presentation current and new procedures, techniques and devices like TNP,HBOT, electrical stimulation, ultrasound, maggot therapy, growth factors and others for treating DFU will be critical reviewed in regard to available evidence. Suggestions for more appropriated outcomes for future research will also be mentioned.  [...]