Cirugía reconstructiva para el tratamiento de las úlceras por presión
Information
- DOI:
- https://doi.org/10.1002/14651858.CD012032.pub3Copy DOI
- Database:
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- Cochrane Database of Systematic Reviews
- Version published:
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- 13 October 2022see what's new
- Type:
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- Intervention
- Stage:
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- Review
- Cochrane Editorial Group:
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Cochrane Wounds Group
- Copyright:
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- Copyright © 2022 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
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Authors
Contributions of authors
GN: designed the review update; coordinated the review update; checked quality of data extraction; analysed or interpreted data; checked quality assessment; produced the first draft of the review update; contributed to writing or editing the review update; wrote to study authors/experts/companies; approved the final review update prior to submission; is guarantor of the review update.
JKFW: conceived the review; contributed to writing or editing the review update; advised on the review update; performed previous work that was the foundation of the current review update; approved the final review update prior to submission.
KA: conceived the review; contributed to writing or editing the review update; advised on the review update; performed previous work that was the foundation of the current review update; approved the final review update prior to submission.
JCD: conceived the review; contributed to writing or editing the review update; secured funding; performed previous work that was the foundation of the current review update; approved the final review update prior to submission.
SP: extracted data; undertook quality assessment; contributed to writing or editing the review update; approved the final review update prior to submission.
Contribution of the editorial base
Nicky Cullum (Joint Co‐ordinating Editor): edited the protocol and the previous version of this review; advised on methodology, interpretation and content; approved the final protocol and the previous version of this review prior to submission.
Gill Rizzello (Managing Editor): co‐ordinated the editorial process; advised on content; edited the protocol and the previous and current versions of the review.
Sophie Bishop (Information Specialist): designed the search strategy, edited the search methods section and ran the searches for the review.
Tom Patterson (Editorial Assistant): drafted the plain language summary for this review update and edited the reference sections.
Sources of support
Internal sources
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Division of Nursing Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, UK
Jo Dumville and Gill Norman
External sources
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National Institute for Health Research, UK
This project was supported by the National Institute for Health Research, via Cochrane Infrastructure funding to Cochrane Wounds. The views expressed are those of the authors and not necessarily those of the NIHR, NHS or the Department of Health and Social Care, UK
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National Institute for Health Research Applied Research Collaboration (ARC) Greater Manchester, UK
Two of the authors are partially funded by the National Institute for Health Research Applied Research Collaboration Greater Manchester. The views expressed in this publication are those of the authors and not necessarily those of the National Institute for Health Research or the Department of Health and Social Care.
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NIHR Manchester Biomedical Research Centre, UK
This review was co‐funded by the NIHR Manchester Biomedical Research Centre. The views expressed in this publication are those of the author(s) and not necessarily those of the NHS, the National Institute for Health Research or the Department of Health and Social Care.
Declarations of interest
GN: is partially funded by the National Institute for Health Research Applied Research Collaboration Greater Manchester. Her employment at the University of Manchester is partially funded by the National Institute for Health Research (NIHR) through Cochrane Wounds. She is an Editor for Cochrane Wounds and was not involved in the editorial process for this review.
JKFW: works as a health professional for Manchester University Foundation Trust and has worked as an independent consultant for Biotherapy Services.
KA: works as a health professional for Manchester University Foundation Trust.
JCD: received research funding from the NIHR for the production of systematic reviews focusing on high‐priority Cochrane Reviews in the prevention and treatment of wounds. This research was co‐funded by the NIHR Manchester Biomedical Research Centre and partly funded by the National Institute for Health Applied Research Collaboration Greater Manchester. JCD is a Joint Co‐ordinating Editor of Cochrane Wounds and was not involved in the editorial process for this review.
SP: works as a health professional for the Christie NHS Foundation Trust. Her work on this review was funded by the NIHR Manchester Biomedical Research Centre.
Acknowledgements
The review authors are grateful to Janet Wale, Julie Bruce and Sharon Van Wicklin for their peer review of this version of the review, and to Julia Turner for copy editing the review. They are also grateful to Chunhu Shi for advice on data extraction, risk of bias and GRADE assessments in this update, and to Tom Patterson for assistance with the plain language summary.
The authors are also grateful to the following peer reviewers for their time and comments on previous versions of the review: Kurinchi Gurusamy, Bryan Chung and Roy Buffery. They would also like to acknowledge the contribution of the following copy editors to previous versions of the review: Jenny Bellorini (protocol) and Denise Mitchell (review).
To retain the independence of the editorial process, the Cochrane Oral Health Editor, Tanya Walsh, signed off this review for publication.
Version history
| Published | Title | Stage | Authors | Version |
| 2022 Oct 13 | Reconstructive surgery for treating pressure ulcers | Review | Gill Norman, Jason KF Wong, Kavit Amin, Jo C Dumville, Susy Pramod | |
| 2016 Dec 06 | Reconstructive surgery for treating pressure ulcers | Review | Jason KF Wong, Kavit Amin, Jo C Dumville | |
| 2016 Jan 07 | Reconstructive surgery for treating pressure ulcers | Protocol | Jason KF Wong, Kavit Amin, Jo C Dumville | |
Differences between protocol and review
We changed our search strategy for this update to include more specific MeSH terms, as the original search retrieved many irrelevant results.
Keywords
MeSH
Medical Subject Headings (MeSH) Keywords
Medical Subject Headings Check Words
Adult; Aged; Humans; Middle Aged; Young Adult;
PICOs
Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
| Cone of pressure flap compared with standard flap technique | ||||||
| Patient or population: people with stage IV pressure ulcers | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect | № of participants | Certainty of the evidence | Comments | |
|---|---|---|---|---|---|---|
| Risk with standard flap | Risk with COP flap | |||||
| Complete healing of surgical wound Follow‐up: 16 months | Study population | Not calculable | 20 (1 RCT) | ⊕⊝⊝⊝ | The included study reported that minor complications, including delayed wound healing and wound dehiscence that did not require surgical intervention, were comparable between the groups. We could not calculate an effect estimate and are uncertain of the effect of the interventions on wound healing. | |
| Not calculable | Not calculable | |||||
| Wound dehiscence Follow‐up: 16 months | Study population | Not calculable | 20 (1 RCT) | ⊕⊝⊝⊝ | The included study reported that minor complications, including delayed wound healing and wound dehiscence that did not require surgical intervention, were comparable between the groups. We could not calculate an effect estimate and are uncertain of the effect of the interventions on wound dehiscence. | |
| Not calculable | Not calculable | |||||
| Pressure ulcer recurrence | Study population | Not calculable | 20 (1 RCT) | ⊕⊝⊝⊝ | The included study did not clearly report the proportion of participants in each group with pressure ulcer recurrence. We could not calculate an effect estimate and are uncertain of the effect of the interventions on ulcer recurrence. | |
| Not calculable | Not calculable | |||||
| *The risk in the intervention group (and its 95% CI) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; COP: cone of pressure; RCT: randomised controlled trial. | ||||||
| GRADE Working Group grades of evidence | ||||||
| aDowngraded two levels for high risk of bias in multiple domains, and two levels for imprecision due to low participant number and incomplete reporting. | ||||||
