Systematic review and meta-analysis of the efficacy of Unna boot in the treatment of venous leg ulcers.

This systematic review determined the effectiveness of the Unna boot in the treatment of venous leg ulcers (VLUs) by assessing the quality of the available evidence. A systematic search of studies published between August 2019 and February 2020 was conducted using the PubMed, PubMed/PMC, BVS/BIREME, CINAHL, Web of Science, MEDLINE, Embase, Cochrane, ProQuest, BDTD, CAPES Thesis and Dissertation, OPEN THESIS, Centre for Reviews and Dissemination and SciELO databases. Studies were eligible if they reported primary studies, controlled clinical trials, quasi-experimental studies or observational studies (cross-sectional studies or cohort studies). We identified 302 articles. After screening and critical appraisal, eight articles were included in this review, while six articles were included in the meta-analysis. Four studies were included in the outcome of complete ulcer healing rate with a weighted estimate of the odds ratio of 0.43 (95% CI = 0.188-1.01). No evidence of the presence of considerable heterogeneity was observed (p = 0.35, I2 = 32%). Two studies were assigned to the outcome time to complete ulcer healing (days) with a weighted estimated mean difference of 41.3 days (95% CI = 21.62-61.04). Evidence of the presence of considerable heterogeneity was observed (p = 0.01, I2 = 85%). The results showed a moderate degree of evidence that there is no difference in the healing rates of VLUs with the use of the Unna boot. For the time to complete ulcer healing, the low number of studies and low classification impaired the reporting at any level of evidence.

A protocol for systematic review of Plantago major L. effectiveness in accelerating wound-healing in animal models.

BACKGROUND: Studies have indicated that Plantago major L. (P. major) has therapeutic properties, such as anti-inflammatory, antioxidant, antifungal, immunostimulatory, and tissue regeneration. This plant species is assumed to provide potent tissue repair and healing in treatments of skin wound injuries, but the understanding of its effectiveness is still unclear. The systematic review proposed herein aims to assess effectiveness of P. major for wound healing in animal models. METHODS: We will conduct database searches in BVS, PubMed, Scopus, Web of Science, CINAHL, and CABDirect. Reviewers will independently evaluate titles, abstracts, and full-text articles retrieved from databases to identify potentially eligible studies. Relevant articles will be assessed for risk of bias and quality. The database searches will include analysis of wound healing rate through macroscopic evaluation, photo images, or calculation of the wound area retraction until the wound closure. Relevant data will be compiled for the capability and effectiveness of P. major treatments in accelerating wound healing. Random effects meta-analysis models will be employed to compare among groups based on outcome variables from studies reporting sufficient high-quality data. DISCUSSION: Results of this systematic review will be presented in a narrative synthesis form. They will provide a summary and clear understanding of the relevant current questions and evidences directly related to P. major effective tissue repair and healing. Outcomes of this systematic review will contribute with important information that could benefit future research efforts and potential applicability in humans. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42019121962.

Assessment of the use of Unna boot in the treatment of chronic venous leg ulcers in adults: systematic review protocol.

INTRODUCTION: Chronic venous insufficiency (CVI) is an anomaly of the normal functioning of the venous system caused by valvular incompetence with or without the obstruction of venous flow. This condition can affect either or both of the superficial and the deep venous systems. Venous dysfunction can even result in congenital or acquired disorders, and its complications include venous leg ulcers (VLUs). The objective of this systematic review is to determine the effectiveness of Unna boot in the treatment of wound healing of VLU by assessing the quality of the available evidence. METHODS AND ANALYSIS: A literature search in PubMed, CINAHL, Scopus, Web of Science, Cochrane Library, BVS/BIREME, Embase, ProQuest, BDTD, Thesis and Dissertation Catalog, Sao Paulo Research Foundation/Thesis and dissertation, OPEN THESIS, A service of the US National Institute of Health, Center for Reviews and Dissemination-University of New York and SciElo published in the last 10 years, the period from January 1999 to March 2019. The review will include primary studies (original), and Controlled Trials or Observational studies (cross-sectional, case-control or longitudinal studies) with VLU. The exclusion will include leg ulceration due to different causes, such as pressure, arterial, diabetic or mixed-aetiology leg ulcers. Data synthesis will be performed using a narrative summary and quantitative analysis. ETHICS AND DISSEMINATION: This systematic review does not require approval by the ethics committee, as individual patient data will not be collected. Dissemination of findings will be through publications in peer-reviewed journals and/or via conference presentations. PROSPERO REGISTRATION NUMBER: CRD42019127947.