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Elektromagnetska terapija za liječenje dekubitalnih ulkusa

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Abstract

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Background

Pressure ulcers are defined as areas "of localized damage to the skin and underlying tissue caused by pressure, shear, friction and/or the combination of these". Electromagnetic therapy (EMT), in which electrodes produce an electromagnetic field across the wound, may improve healing of chronic wounds such as pressure ulcers.

Objectives

To assess the effects of EMT on the healing of pressure ulcers.

Search methods

For this update we searched the Cochrane Wounds Group Specialised Register (searched 12 July 2012); The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2012, Issue 7); Ovid MEDLINE (2010 to July Week 1 2012); Ovid MEDLINE (In‐Process & Other Non‐Indexed Citations, July 11, 2012); Ovid EMBASE (2010 to 2012 Week 27); and EBSCO CINAHL (2010 to 6 July 2012).

Selection criteria

Randomised controlled trials comparing EMT with sham EMT or other (standard) treatment.

Data collection and analysis

For this update two review authors independently scrutinised the results of the search to identify relevant RCTs and obtained full reports of potentially eligible studies. In previous versions of the review we made attempts to obtain missing data by contacting study authors. A second review author checked data extraction and disagreements were resolved after discussion between review authors.

Main results

We identified no new trials for this update.Two randomised controlled trials (RCTs), involving 60 participants, at unclear risk of bias were included in the original review. Both trials compared the use of EMT with sham EMT, although one of the trials included a third arm in which only standard therapy was applied. Neither study found a statistically significant difference in complete healing in people treated with EMT compared with those in the control group. In one trial that assessed percentage reduction in wound surface area, the difference between the two groups was reported to be statistically significant in favour of EMT. However, this result should be interpreted with caution as this is a small study and this finding may be due to chance. Additionally, the outcome, percentage reduction in wound area, is less clinically meaningful than complete healing.

Authors' conclusions

The results provide no strong evidence of benefit in using EMT to treat pressure ulcers. However, the possibility of a beneficial or harmful effect cannot be ruled out because there were only two included trials, both with methodological limitations and small numbers of participants. Further research is recommended.

PICO

Population
Intervention
Comparison
Outcome

El uso y la enseñanza del modelo PICO están muy extendidos en el ámbito de la atención sanitaria basada en la evidencia para formular preguntas y estrategias de búsqueda y para caracterizar estudios o metanálisis clínicos. PICO son las siglas en inglés de cuatro posibles componentes de una pregunta de investigación: paciente, población o problema; intervención; comparación; desenlace (outcome).

Para saber más sobre el uso del modelo PICO, puede consultar el Manual Cochrane.

Plain language summary

Elektromagnetska terapija za liječenje dekubitalnih ulkusa

Dekubitalni ulkusi (nazivaju se i rane uslijed ležanja, dekubitus ili dekubitalne rane) su rane na koži uzrokovane pritiskom ili trljanjem kože. Oni se obično javljaju kod nepokretnih osoba na koščatim dijelovima tijela, kao što su bokovi, pete i laktovi, te dugo vremena zacijeljuju. Elektromagnetska terapija nije oblik zračenja ili grijanja, već koristi elektromagnetsko polje s ciljem poticanja cijeljenja. Međutim, ovaj je Cochrane sustavni pregled istraživanja zaključio kako ne postoji jak dokaz da elektromagnetska terapija pomaže ili ometa cijeljenje dekubitusa.