Wound cleansing for treating venous leg ulcers

Area of Science:

• Wound healing research
• Dermatology
• Clinical trials

Background:

• Leg ulcers are chronic wounds below the knee, often caused by venous insufficiency.
• Compression therapy is the primary treatment, but wound cleansing effectiveness remains uncertain.
• Optimal cleansing solutions and techniques for venous leg ulcers require further investigation.

Purpose of the Study:

• To assess the effects of wound cleansing, solutions, and techniques for venous leg ulcers.
• To evaluate current evidence on wound cleansing interventions for leg ulcers.

Main Methods:

• Systematic review of randomized controlled trials (RCTs).
• Searched multiple databases including Cochrane Wounds, MEDLINE, Embase, and CINAHL up to September 2019.
• Included four studies comparing different cleansing solutions; no studies compared cleansing to no cleansing or different techniques.

Main Results:

• Included four studies with 254 participants, comparing various cleansing solutions (PHMB, aqueous oxygen peroxide, propyl betaine/polihexanide, OHP) against controls (saline, sterile water, Ringer's solution).
• Insufficient evidence to determine the effectiveness of any specific cleansing solution for healing, ulcer size reduction, or pain.
• Evidence quality was very low due to study limitations and imprecision; one study did not report primary outcomes.

Conclusions:

• Lack of robust RCT evidence to guide clinical decisions on wound cleansing for venous leg ulcers.
• Current evidence is insufficient to support specific cleansing solutions over others.
• Further well-designed studies are needed to address clinical, quality of life, and economic outcomes in venous leg ulcer management.