Treatment of pressure ulcers: a clinical practice guideline from the American College of Physicians.
METHODS
The American College of Physicians (ACP) developed this guideline to present the evidence and provide clinical recommendations based on the comparative effectiveness of treatments of pressure ulcers.


METHODS
This guideline is based on published literature on this topic that was identified by using MEDLINE, EMBASE, CINAHL, EBM Reviews, the Cochrane Central Register of Controlled Trials, the Cochrane Database of Systematic Reviews, the Database of Abstracts of Reviews of Effects, and the Health Technology Assessment database through February 2014. Searches were limited to English-language publications. The outcomes evaluated for this guideline include complete wound healing, wound size (surface area, volume, and depth) reduction, pain, prevention of sepsis, prevention of osteomyelitis, recurrence rate, and harms of treatment (including but not limited to pain, dermatologic complications, bleeding, and infection). This guideline grades the quality of evidence and strength of recommendations by using ACP's clinical practice guidelines grading system. The target audience for this guideline includes all clinicians, and the target patient population is patients with pressure ulcers.


CONCLUSIONS
ACP recommends that clinicians use protein or amino acid supplementation in patients with pressure ulcers to reduce wound size. (Grade: weak recommendation, low-quality evidence).


CONCLUSIONS
ACP recommends that clinicians use hydrocolloid or foam dressings in patients with pressure ulcers to reduce wound size. (Grade: weak recommendation, low-quality evidence).


CONCLUSIONS
ACP recommends that clinicians use electrical stimulation as adjunctive therapy in patients with pressure ulcers to accelerate wound healing. (Grade: weak recommendation, moderate-quality evidence).
Amir
A
Qaseem
Linda L
LL
Humphrey
Mary Ann
MA
Forciea
Melissa
M
Starkey
Thomas D
TD
Denberg
D000596:Amino Acids / Q000008:administration & dosage; D047070:Bandages, Hydrocolloid; D057186:Comparative Effectiveness Research; D004044:Dietary Proteins / Q000008:administration & dosage; D019587:Dietary Supplements; D004599:Electric Stimulation Therapy; D006801:Humans; D003668:Pressure Ulcer / Q000628:therapy*; D012008:Recurrence; D014945:Wound Healing
D000596:Amino Acids; D004044:Dietary Proteins