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Chronic venous leg ulcer treatment: future research needs
Gerald Lazarus1, M Fran Valle, Mahmoud Malas
1Departments of Dermatology, Medicine and Surgery, School of Medicine, Johns Hopkins University, Queenstown, Maryland.
Insights
Chronic venous ulcer care faces rising costs. Research highlights a need for high-quality studies on advanced wound dressings, venous surgery, and antibiotics to improve patient outcomes and justify treatment expenses.
Area of Science:
- Wound Care
- Vascular Surgery
- Evidence-Based Medicine
Background:
- Chronic venous ulcers represent a growing healthcare burden in the US, with increasing prevalence and associated costs.
- Existing evidence on interventions for chronic venous ulcers is limited, necessitating a critical review of research quality and effectiveness.
Purpose of the Study:
- To systematically review the comparative effectiveness of advanced wound dressings, antibiotics, and surgical management for chronic venous ulcers.
- To identify research gaps and methodological deficiencies in current literature and prioritize future research needs.
- To guide the development of high-quality evidence for therapeutic modalities in chronic venous ulcer care.
Main Methods:
- A systematic literature search identified 10,066 citations, of which only 66 met inclusion criteria for evidence on intervention effectiveness.
- A panel of experts and stakeholders reviewed the selected studies to assess comparative effectiveness and identify research priorities.
Main Results:
- Advanced wound dressings were identified as the highest priority for future research.
- Venous surgery and antibiotic therapies were ranked as secondary research priorities.
- Significant methodological deficiencies were noted in the existing body of research.
Conclusions:
- There is an urgent need for high-quality research to evaluate interventions for chronic venous ulcers.
- Future studies must adhere to rigorous quality standards to generate reliable evidence.
- Developing robust evidence is crucial for justifying current and future therapeutic strategies amidst increasing cost pressures.
Abstract:
The prevalence and costs of chronic venous ulcer care in the US are increasing. The Johns Hopkins University Evidence-Based Practice Center recently completed a systematic review of the comparative effectiveness of advanced wound dressings, antibiotics, and surgical management of chronic venous ulcers. Of 10,066 citations identified in the literature search, only 66 (0.06%) met our liberal inclusion criteria for providing evidence on the effectiveness of interventions for chronic venous ulcers. Based on review of those studies, members of our team and a panel of informed stakeholders identified important research gaps and methodological deficiencies and prioritized specific future research needs. Based on that review, we provide the results of our assessment of future research needs for chronic venous ulcer care. Advanced wound dressings were considered to have the highest priority for future research, followed by venous surgery and antibiotics. An imperative from our assessment is that future research evaluating interventions for chronic venous ulcers meet quality standards. In a time of increasing cost pressure, the wound care community needs to develop high-quality evidence to justify the use of present and future therapeutic modalities.
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