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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.

Predicted factors of surgical site infection in glioblastoma patients: A meta‐analysis

Abstract

Surgical site infection (SSI) is one of the common postoperative complications after craniotomy for glioblastoma patients. Previous studies have investigated the risk factors for SSI in patients with glioblastoma. Whereas big differences in research results exist, and the correlation coefficients of different research results are quite different. A meta-analysis was conducted to examine the risk factors related to surgical site infection in patients with glioblastoma. We searched English databases to collect case–control studies or cohort studies published before 15 October 2023 including PubMed, Web of Science, Embase. The risk of bias of the included studies was assessed via Newcastle-Ottawa Scale. The analysis was performed using RevMan 5.4.1 tool. A total of 4 articles (n = 2222) were selected in this meta-analysis. The following risk factors were presented to be correlated with SSI in glioblastoma: irradiation (OR = 1.88, 95% CI [0.46, 7.60]), more than 3 surgeries (OR = 2.99, 95% CI [1.47, 6.08]). Occurrence of SSI is influenced by a variety of factors. Thus, we should pay close attention to high-risk subjects and take crucial targeted interventions to lower the SSI risk following craniotomy. Owing to the limited quality and quantity of the included studies, more rigorous studies with adequate sample sizes are needed to verify the conclusion.

In vitro prevention and inactivation of biofilms using controlled‐release iodine foam dressings for wound healing

Abstract

Microbial biofilms are a major hindrance in the wound healing process, prolonging the inflammatory response phase, thus making them a target in treatment. The aim of this study is to assess the antibacterial properties of commercially available wound dressings, of various material composition and antibacterial agents, towards multiple in vitro microbial and biofilm models. A variety of in vitro microbial and biofilm models were utilised to evaluate the ability of wound dressing materials to sequester microbes, prevent dissemination and manage bioburden. Sequestering and dissemination models were used to evaluate the ability of wound dressing materials to prevent the biofilm-forming bacterium, Pseudomonas aeruginosa, from migrating through dressing materials over a 24–72 h challenge period. Additionally, Centre for Disease Control (CDC) Bioreactor and Drip Flow models were used to evaluate antibacterial killing efficacy towards established P. aeruginosa and Staphylococcus aureus biofilms using more challenging, wound-like models. Controlled-release iodine foam and silver-impregnated carboxymethylcellulose (CMC) wound dressing materials demonstrated potent biofilm management properties in comparison to a methylene blue and gentian violet-containing foam dressing. Both the iodine-containing foam and silver-impregnated CMC materials effectively prevented viable P. aeruginosa dissemination for up to 72 h. In addition, the controlled-release iodine foam and silver-impregnated CMC materials reduced P. aeruginosa bioburden in the Drip Flow model. The controlled-release iodine foam demonstrated superiority in the CDC Bioreactor model, as both the silver- and iodine-containing materials reduced S. aureus to the limit of detection, but P. aeruginosa growth was only completely reduced by controlled-release iodine foam dressing materials. The data generated within the in vitro biofilm models supports the clinical data available in the public domain for the implementation of iodine foam dressings for effective biofilm management and control in wound care.

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