Optimal evidence summary for chronic wounds exudate management_West China Medical Journal

Authors：

DENG Xin ¹ , HU Rong ² , LI Peifang ³ ,  YU Rong ¹

1. Department of Otolaryngology-Head & Neck Surgery, West China Hospital, Sichuan University / West China School of Nursing, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Department of Orthopaedics, Mianyang Central Hospital, Mianyang, Sichuan 621000, P. R. China;
3. Department of Orthopedic Surgery, West China Hospital, Sichuan University / West China School of Nursing, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

YU Rong, Email: entyurong@163.com

Keywords：

Chronic wounds; exudate management; systematic review; negative pressure system; new treatment concepts; quality evaluation; evidence summary

DOI：

10.7507/1002-0179.202401087

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Objective To summarize the optimal evidence for improving the management of chronic wounds exudate, so as to provide evidence-based references for medical professionals, therapists, patients, and their caregivers. Methods PubMed, Wanfang, CNKI, Medlive, UpToDate, etc., were searched by computer for literature about chronic trauma exudate management. The retrieval time limit was from 1998 to 2023. Two researchers trained in evidence-based practice evaluated the quality of the included literature and finally extracted evidence from the literature that met the quality evaluation criteria. Results A total of 11 articles were included, including 2 expert consensuses, 7 systematic reviews, 1 randomized controlled trial, and 1 guideline, covering 7 aspects of the assessment of the nature of chronic wounds exudate, selection of exudate assessment tools, management of antimicrobial concerns, selection and application of wound dressings, negative pressure wound drainage therapy, wound drainage bags, and affected limb elevation or compression therapy for patients with venous leg ulcers. A total of 13 best evidences were extracted. Conclusions When applying evidence, medical professionals should fully evaluate and combine the individual circumstances of the patient, make full use of existing resources, new treatment concepts and technologies, and carry out comprehensive integrated management. This can optimize the management of chronic wounds exudate and improve the quality of life of patients.

Citation： DENG Xin, HU Rong, LI Peifang, YU Rong. Optimal evidence summary for chronic wounds exudate management. West China Medical Journal, 2024, 39(6): 927-933. doi: 10.7507/1002-0179.202401087 Copy

1.	Adderley UJ. Managing wound exudate and promoting healing. Br J Community Nurs, 2010, 15(3): S15-S16,S18,S20.
2.	Wu X, Liu R, Lao TT. Therapeutic compression materials and wound dressings for chronic venous insufficiency: a comprehensive review. J Biomed Mater Res B Appl Biomater, 2020, 108(3): 892-909.
3.	Tickle J. Wound exudate: a survey of current understanding and clinical competency. Br J Nurs, 2016, 25(2): 102-109.
4.	Whitehead F, Giampieri S, Graham T, et al. Identifying, managing and preventing skin maceration: a rapid review of the clinical evidence. J Wound Care, 2017, 26(4): 159-165.
5.	朱政, 胡雁, 邢唯杰, 等. 不同类型循证问题的构成. 护士进修杂志, 2017, 32(21): 1991-1994.
6.	Jiang Y, Han W, Jiang L, et al. Establishment and obstacle analysis of evidence-based nursing indexes for unplanned hypothermia management in patients undergoing laparoscopic operation. Gland Surg, 2022, 11(3): 545-555.
7.	韦当, 王聪尧, 肖晓娟, 等. 指南研究与评价(AGREEⅡ)工具实例解读. 中国循证儿科杂志, 2013, 8(4): 316-319.
8.	周英凤, 顾莺, 胡雁, 等. JBI 循证卫生保健中心关于不同类型研究的质量评价工具——干预性研究的质量评价(二). 护士进修杂志, 2018, 33(2): 112-113.
9.	Lu Y, Yuan Z, Han Y, et al. Summary of best evidence for enhanced recovery after surgery for patients undergoing lung cancer operations. Asia Pac J Oncol Nurs, 2022, 9(7): 100054.
10.	Chen H, Zhou C, Yu M, et al. The effect of ginkgo biloba dropping pills on hemorheology and blood lipid: a systematic review of randomized trials. Evid Based Complement Alternat Med, 2019, 2019: 2609625.
11.	王春青, 胡雁. JBI 证据预分级及证据推荐级别系统 (2014 版). 护士进修杂志, 2015, 30(11): 964-967.
12.	Hasegawa M, Inoue Y, Kaneko S, et al. , Wound, pressure ulcer and burn guidelines - 1: guidelines for wounds in general, second edition. J Dermatol, 2020, 47(8): 807-833.
13.	徐慧敏, 吴娟, 李萍. 伤口渗液管理的研究现状. 临床皮肤科杂志, 2018, 47(6): 389-392.
14.	Moore Z, Strapp H. Managing the problem of excess exudate. Br J Nurs, 2015, 24(15): S12,S14-S17.
15.	Evans K, Kim PJ. Overview of treatment of chronic wounds. Official reprint from UpToDate: 2022-7-13.
16.	Benbow M, Stevens J. Exudate, infection and patient quality of life. Br J Nurs, 2010, 19(20): S30,S32-S36.
17.	姚泽欣, 付小兵, 程飚. 慢性创面愈合新理念: 姑息性创面治疗的研究进展. 中华烧伤杂志, 2020, 36(8): 754-757.
18.	Grocott P. Exudate management in fungating wounds. J Wound Care, 1998, 7(9): 445-448.
19.	金鲜珍, 廖新华, 辛霞, 等. 自制密闭式负压系统在伤口渗液管理中的应用研究. 护理学报, 2015, 22(17): 62-64.
20.	Moloney S. The challenges of wound management for hidradenitis suppurativa. Br J Nurs, 2022, 31(4): S34-S41.
21.	Crespi G, Giannetta E, Mariani F, et al. Imaging of early postoperative complications after polypropylene mesh repair of inguinal hernia. Radiol Med, 2004, 108(1/2): 107-115.
22.	Brett DW. Impact on exudate management, maintenance of a moist wound environment, and prevention of infection. J Wound Ostomy Continence Nurs, 2006, 33(Suppl 6): S9-S14.
23.	Walzer S, Dröschel D, Vollmer L, et al. A cost-effectiveness analysis of a hydration response technology dressing in the treatment of venous leg ulcers in the UK. J Wound Care, 2018, 27(3): 166-172.
24.	Cutting KF. Wound healing through synergy of hyaluronan and an iodine complex. J Wound Care, 2011, 20(9): 424,426,428-430.
25.	Powers JG, Higham C, Broussard K, et al. Wound healing and treating wounds: chronic wound care and management. J Am Acad Dermatol, 2016, 74(4): 607-625.
26.	Broughton G 2nd, Janis JE, Attinger CE. Attinger, The basic science of wound healing. Plast Reconstr Surg, 2006, 117(Suppl 7): S12-S34.
27.	Krug E, Berg L, Lee C, et al. Evidence-based recommendations for the use of negative pressure wound therapy in traumatic wounds and reconstructive surgery: steps towards an international consensus. Injury, 2011, 42(Suppl 1): S1-S12.
28.	Argenta LC, Morykwas MJ. Vacuum-assisted closure: a new method for wound control and treatment: clinical experience. Ann Plast Surg, 1997, 38(6): 563-576.
29.	Nelson EA, Adderley U. Venous leg ulcers. BMJ Clin Evid, 2016: 1902.
30.	黄剑, 周大勇, 沈利明, 等. 下肢静脉性溃疡患者小腿穿静脉功能不全评估方法比较. 介入放射学杂志, 2012, 21(11): 907-911.
31.	Padberg FT Jr, Johnston MV, Sisto SA. Structured exercise improves calf muscle pump function in chronic venous insufficiency: a randomized trial. J Vasc Surg, 2004, 39(1): 79-87.
32.	Dayya D, O'Neill OJ, Huedo-Medina TB, et al. Debridement of diabetic foot ulcers. Adv Wound Care (New Rochelle), 2022, 11(12): 666-686.
33.	Marston W, Tang J, Kirsner RS, et al. Wound healing society 2015 update on guidelines for venous ulcers. Wound Repair Regen, 2016, 24(1): 136-144.
34.	Edwards H, Finlayson K, Skerman H, et al. Identification of symptom clusters in patients with chronic venous leg ulcers. J Pain Symptom Manage, 2014, 47(5): 867-875.

1. Adderley UJ. Managing wound exudate and promoting healing. Br J Community Nurs, 2010, 15(3): S15-S16,S18,S20.
2. Wu X, Liu R, Lao TT. Therapeutic compression materials and wound dressings for chronic venous insufficiency: a comprehensive review. J Biomed Mater Res B Appl Biomater, 2020, 108(3): 892-909.
3. Tickle J. Wound exudate: a survey of current understanding and clinical competency. Br J Nurs, 2016, 25(2): 102-109.
4. Whitehead F, Giampieri S, Graham T, et al. Identifying, managing and preventing skin maceration: a rapid review of the clinical evidence. J Wound Care, 2017, 26(4): 159-165.
5. 朱政, 胡雁, 邢唯杰, 等. 不同类型循证问题的构成. 护士进修杂志, 2017, 32(21): 1991-1994.
6. Jiang Y, Han W, Jiang L, et al. Establishment and obstacle analysis of evidence-based nursing indexes for unplanned hypothermia management in patients undergoing laparoscopic operation. Gland Surg, 2022, 11(3): 545-555.
7. 韦当, 王聪尧, 肖晓娟, 等. 指南研究与评价(AGREEⅡ)工具实例解读. 中国循证儿科杂志, 2013, 8(4): 316-319.
8. 周英凤, 顾莺, 胡雁, 等. JBI 循证卫生保健中心关于不同类型研究的质量评价工具——干预性研究的质量评价(二). 护士进修杂志, 2018, 33(2): 112-113.
9. Lu Y, Yuan Z, Han Y, et al. Summary of best evidence for enhanced recovery after surgery for patients undergoing lung cancer operations. Asia Pac J Oncol Nurs, 2022, 9(7): 100054.
10. Chen H, Zhou C, Yu M, et al. The effect of ginkgo biloba dropping pills on hemorheology and blood lipid: a systematic review of randomized trials. Evid Based Complement Alternat Med, 2019, 2019: 2609625.
11. 王春青, 胡雁. JBI 证据预分级及证据推荐级别系统 (2014 版). 护士进修杂志, 2015, 30(11): 964-967.
12. Hasegawa M, Inoue Y, Kaneko S, et al. , Wound, pressure ulcer and burn guidelines - 1: guidelines for wounds in general, second edition. J Dermatol, 2020, 47(8): 807-833.
13. 徐慧敏, 吴娟, 李萍. 伤口渗液管理的研究现状. 临床皮肤科杂志, 2018, 47(6): 389-392.
14. Moore Z, Strapp H. Managing the problem of excess exudate. Br J Nurs, 2015, 24(15): S12,S14-S17.
15. Evans K, Kim PJ. Overview of treatment of chronic wounds. Official reprint from UpToDate: 2022-7-13.
16. Benbow M, Stevens J. Exudate, infection and patient quality of life. Br J Nurs, 2010, 19(20): S30,S32-S36.
17. 姚泽欣, 付小兵, 程飚. 慢性创面愈合新理念: 姑息性创面治疗的研究进展. 中华烧伤杂志, 2020, 36(8): 754-757.
18. Grocott P. Exudate management in fungating wounds. J Wound Care, 1998, 7(9): 445-448.
19. 金鲜珍, 廖新华, 辛霞, 等. 自制密闭式负压系统在伤口渗液管理中的应用研究. 护理学报, 2015, 22(17): 62-64.
20. Moloney S. The challenges of wound management for hidradenitis suppurativa. Br J Nurs, 2022, 31(4): S34-S41.
21. Crespi G, Giannetta E, Mariani F, et al. Imaging of early postoperative complications after polypropylene mesh repair of inguinal hernia. Radiol Med, 2004, 108(1/2): 107-115.
22. Brett DW. Impact on exudate management, maintenance of a moist wound environment, and prevention of infection. J Wound Ostomy Continence Nurs, 2006, 33(Suppl 6): S9-S14.
23. Walzer S, Dröschel D, Vollmer L, et al. A cost-effectiveness analysis of a hydration response technology dressing in the treatment of venous leg ulcers in the UK. J Wound Care, 2018, 27(3): 166-172.
24. Cutting KF. Wound healing through synergy of hyaluronan and an iodine complex. J Wound Care, 2011, 20(9): 424,426,428-430.
25. Powers JG, Higham C, Broussard K, et al. Wound healing and treating wounds: chronic wound care and management. J Am Acad Dermatol, 2016, 74(4): 607-625.
26. Broughton G 2nd, Janis JE, Attinger CE. Attinger, The basic science of wound healing. Plast Reconstr Surg, 2006, 117(Suppl 7): S12-S34.
27. Krug E, Berg L, Lee C, et al. Evidence-based recommendations for the use of negative pressure wound therapy in traumatic wounds and reconstructive surgery: steps towards an international consensus. Injury, 2011, 42(Suppl 1): S1-S12.
28. Argenta LC, Morykwas MJ. Vacuum-assisted closure: a new method for wound control and treatment: clinical experience. Ann Plast Surg, 1997, 38(6): 563-576.
29. Nelson EA, Adderley U. Venous leg ulcers. BMJ Clin Evid, 2016: 1902.
30. 黄剑, 周大勇, 沈利明, 等. 下肢静脉性溃疡患者小腿穿静脉功能不全评估方法比较. 介入放射学杂志, 2012, 21(11): 907-911.
31. Padberg FT Jr, Johnston MV, Sisto SA. Structured exercise improves calf muscle pump function in chronic venous insufficiency: a randomized trial. J Vasc Surg, 2004, 39(1): 79-87.
32. Dayya D, O'Neill OJ, Huedo-Medina TB, et al. Debridement of diabetic foot ulcers. Adv Wound Care (New Rochelle), 2022, 11(12): 666-686.
33. Marston W, Tang J, Kirsner RS, et al. Wound healing society 2015 update on guidelines for venous ulcers. Wound Repair Regen, 2016, 24(1): 136-144.
34. Edwards H, Finlayson K, Skerman H, et al. Identification of symptom clusters in patients with chronic venous leg ulcers. J Pain Symptom Manage, 2014, 47(5): 867-875.

West China Medical Journal

Optimal evidence summary for chronic wounds exudate management

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