Obtaining the evidence for clinically effective wound care

In tissue viability, as in other aspects of health care, there is increasing recognition of the need for healthcare interventions to be supported by good research evidence. The randomized controlled trial (RCT) is considered to provide the most accurate evidence of effectiveness. This article discusses some of the problems that arise when researchers attempt to obtain the relevant evidence. They include funding, sample selection, sample size, recruitment of patients, and mortality and attrition rates. These points are illustrated by means of a case study. In this study an RCT was undertaken to compare two dressings for the management of pressure sores. Problems arose with recruitment of patients to the study. Relevant issues associated with this are discussed and recommendations for future recruitment are presented.