Reliability of evidence supporting the role of electrical stimulation in the treatment of pressure ulcers

Abstract

To systematically appraise the evidence from overlapping systematic reviews/meta-analyses (SRs/MAs) on electrical stimulation for pressure ulcers. A thorough search of public databases was conducted to collect SRs/MAs on electrical stimulation for pressure ulcers. Two independent authors used the AMSTAR-2 tool, the PRISMA checklists and the GRADE system to appraise the methodological quality, reporting quality and evidence quality of eligible SRs/MAs. Ten eligible SRs/MAs were included. The methodological quality of two SRs/MAs were determined to be high, six were determined to be very low and two were assessed as being of low quality. For PRISMA checklists, potential factors that undermined the quality of reporting were the lack of reporting on the registration of protocols, search, additional analysis of methodology and additional analysis of results. With GRADE, the evidence quality of two outcomes were determined to be moderate, six were determined to be low and two were assessed as being of very low quality. Electrical stimulation appears to be an adjunctive therapy that may promote the healing of pressure ulcers, but the available evidence suggests caution in recommending electrical stimulation widely for the treatment of pressure ulcers. Large-scale trials are the focus of future research to find out how electrical stimulation affects all important outcomes.