Wound-care teams for preventing and treating pressure ulcers (bed sores)

Background

Pressure ulcers (bed sores) are wounds that occur on the skin or underlying tissues. These wounds commonly occur in people who cannot move themselves. The wounds are difficult to heal. Therefore, it is important to try to prevent them from occurring in the first place. However, when they occur, it is also important to manage the wounds properly. A wound-care team is expected to deliver better outcomes for people with these wounds. This is when care is compared to the person being managed by only one health professional alone.

Review question

We wanted to discover the impact that a wound-care team has on the prevention or healing of pressure ulcers. We were interested in studies that included a team that focused on pressure ulcer prevention. We were also interested in studies that focused on treatment of pressure ulcers. The study could include people of any age. The setting where the care was provided could include any type of hospital or nursing home or the person's own home. The study could include people with pressure ulcers or at risk of developing pressure ulcers.

What we found

We searched for studies on 7 April 2015 and found no studies. Because we found no studies to include in this review, we cannot say whether wound-care teams improve the prevention or management of pressure ulcers. Therefore, the impact of wound-care teams on the prevention and management of pressure ulcers needs to be studied.

The evidence of this review is up-to-date as of 7 April 2015.

Authors' conclusions: 

We set out to evaluate the RCT evidence pertaining to the impact of wound-care teams on the prevention and management of pressure ulcers. However, no studies met the inclusion criteria. There is a lack of evidence concerning whether wound-care teams make a difference to the incidence or healing of pressure ulcers. Well-designed trials addressing important clinical, quality of life and economic outcomes are justified, based on the incidence of the problem and the high costs associated with pressure ulcer management.

Read the full abstract...
Background: 

Pressure ulcers, which are localised injury to the skin or underlying tissue, or both, occur when people are unable to reposition themselves to relieve pressure on bony prominences. Pressure ulcers are often difficult to heal, painful and impact negatively on the individual's quality of life. The cost implications of pressure ulcer treatment are considerable, compounding the challenges in providing cost effective, efficient health service delivery. International guidelines suggest that to prevent and manage pressure ulcers successfully a team approach is required. Therefore, this review has been conducted to clarify the role of wound-care teams in the prevention and management of pressure ulcers.

Objectives: 

To assess the impact of wound-care teams in preventing and treating pressure ulcers in people of any age, nursed in any healthcare setting.

Search strategy: 

In April 2015 we searched: The Cochrane Wounds Group Specialised Register; The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library); Ovid MEDLINE; Ovid MEDLINE (In-Process & Other Non-Indexed Citations); Ovid EMBASE and EBSCO CINAHL. There were no restrictions with respect to language, date of publication or study setting.

Selection criteria: 

We considered RCTs that evaluated the effect of any configuration of wound-care teams in the treatment or prevention of pressure ulcers.

Data collection and analysis: 

Two review authors independently assessed titles and, where available, abstracts of the studies identified by the search strategy for their eligibility. We obtained full versions of potentially relevant studies and two review authors independently screened these against the inclusion criteria.

Main results: 

We identified no studies that met the inclusion criteria.