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Chronic ulcers in the elderly – prevention and treatment

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SBU Assessment

Presents a comprehensive, systematic assessment of available scientific evidence for effects on health, social welfare or disability. Full assessments include economic, social and ethical impact analyses. Assessment teams include professional practitioners and academics. Before publication the report is reviewed by external experts, and scientific conclusions approved by the SBU Board of Directors.

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Published: Report no: 226

Conclusions

  • The scientific evidence for the prevention and treatment of chronic ulcers in the elderly is limited. For the majority of interventions, more research of good scientific quality is required. The elderly population often has co-morbidities and multiple medications, which can affect ulcer healing and introduce bias into the studies.
  • It is unclear to what extent different methods for the treatment and prevention of chronic ulcers are currently used in clinical praxis in Sweden. Based on this review the following conclusions can be drawn:
    • Surgery of varicose veins can reduce the recurrence of venous leg ulcers in the elderly.
    • Dressings containing calcium alginate may lead to shorter healing time of pressure ulcers in the elderly. Healing effects of other dressings in this specific age group are insufficiently studied.
  • Substantial gaps in our knowledge exist regarding how the organisation of wound management (wound healing centres, education and training, communication, coordination and continuity) impacts both the healing and recurrence of chronic ulcers.
  • Varicose vein surgery as causal treatment of venous leg ulcers can be cost effective.

How to cite this report: SBU. Chronic ulcers in the elderly – prevention and treatment. Stockholm: Swedish Council on Health Technology Assessment (SBU); 2014. SBU report no 226 (in Swedish).

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