Using different designs in wound healing research

Wounds are common, expensive to treat and prevent patients from returning to their normal activities. Wound healing as a clinical specialty has only developed over the past 20 years, and this is an area of practice where there is a very strong impetus towards ensuring that, as far as possible, all health care is evidence based. Scientific wound healing research has a long history, but clinical research in this field is much more recent. Clinical wound healing research has particular challenges related to the nature of the patients and the interventions being studied. Wounds are a symptom, rather than a disease, and patients often present with multiple or complex pathology. Wound healing interventions typically include dressings, bandages and mattresses, all of which are highly visible to researchers and patients alike. This makes the design and execution of experimental studies challenging. For example, the 'blinding' of researchers, patients and staff to highly visible interventions is very difficult. In this article, Sue Bale discusses the use of four different designs that have been employed: case studies, non-comparative studies, quasi-experimental studies, and randomised controlled trials. The value and contribution of each is explored.