ABSTRACT
OBJECTIVE: To analyze the effect of Unna's Boot on the healing of venous ulcers compared to other therapies. METHODS: Systematic Review carried out in the databases Scopus, Embase, Cochrane Library, Web of Science, PubMed, Cumulative Index of Nursing and Allied Health Literature, Latin American and Caribbean Literature in Health Sciences, and grey literature. Population - adult patients with venous ulcers; Intervention- Unna's Boot (UB); Control - other compression therapies (CT); Outcome- healing; Designs- randomized clinical trial, cohort study, and case control, published from 2001 to 2024. The effect of the intervention, risk of bias, and quality of evidence were evaluated. Registered with PROSPERO (CRD42021290077). RESULTS: A total of 39 studies were included, with 5.151 patients. The majority (71.8%) were randomized controlled trials (RCT). UB was used as intervention/control in eight studies. When comparing CTs, only 1 study with UB showed a superior effect (p < .001) in healing, compared with high compression elastic bandage. In the quality of evidence analysis, 27 studies were assessed as having a high risk of bias. CONCLUSION: No superiority of UB was found in the healing of venous ulcers when compared to other CTs.
Subject(s)
Varicose Ulcer , Wound Healing , Humans , Compression Bandages , Randomized Controlled Trials as Topic , Varicose Ulcer/therapyABSTRACT
ABSTRACT Objective: To analyze the effect of Unna's Boot on the healing of venous ulcers compared to other therapies. Methods: Systematic Review carried out in the databases Scopus, Embase, Cochrane Library, Web of Science, PubMed, Cumulative Index of Nursing and Allied Health Literature, Latin American and Caribbean Literature in Health Sciences, and grey literature. Population - adult patients with venous ulcers; Intervention- Unna's Boot (UB); Control - other compression therapies (CT); Outcome- healing; Designs- randomized clinical trial, cohort study, and case control, published from 2001 to 2024. The effect of the intervention, risk of bias, and quality of evidence were evaluated. Registered with PROSPERO (CRD42021290077). Results: A total of 39 studies were included, with 5.151 patients. The majority (71.8%) were randomized controlled trials (RCT). UB was used as intervention/control in eight studies. When comparing CTs, only 1 study with UB showed a superior effect (p < .001) in healing, compared with high compression elastic bandage. In the quality of evidence analysis, 27 studies were assessed as having a high risk of bias. Conclusion: No superiority of UB was found in the healing of venous ulcers when compared to other CTs.
RESUMEN Objetivo: Analizar el efecto de la Bota de Unna en la cicatrización de úlceras venosas en comparación con otras terapias. Métodos: Revisión sistemática realizada en las bases de datos Scopus, Embase, Biblioteca Cochrane, Web de la Ciencia, PubMed, Índice acumulativo de literatura de enfermería y salud afines, Literatura Latinoamericana y del Caribe en Ciencias de la Salud, y literatura gris. Población - pacientes adultos con úlceras venosas; Intervención- Bota de Unna (BU); Control: otras terapias de compresión (TC); Resultado- curación; Diseños: ensayo clínico aleatorizado, estudio de cohorte y casos y controles, publicado del 2002 al 2023. Se evaluaron el efecto de la intervención, el riesgo de sesgo y la calidad de la evidencia. Registrada en PRÓSPERO (CRD42021290077). Resultados: Se incluyeron 39 estudios, con 5.151 pacientes. La mayoría (71,8%) fueron ensayos controlados aleatorios (ECA). La BU se utilizó como intervención/control en ocho estudios. Al comparar TC, sólo 1 estudio con BU mostró un efecto superior (p < .001) en la curación, en comparación con el vendaje elástico de alta compresión. En el análisis de la calidad de la evidencia, se evaluó que 27 estudios tenían un alto riesgo de sesgo. Conclusión: No se encontró superioridad de la BU en la curación de úlceras venosas en comparación con otras TC.
RESUMO Objetivo: Analisar o efeito da Bota de Unna na cicatrização de úlceras venosas em comparação com outras terapias. Métodos: Revisão Sistemática realizada nas bases de dados Scopus, Embase, Cochrane Library, Web of Science, PubMed, Cumulative Index of Nursing and Allied Health Literature, Literatura Latino-Americana e do Caribe em Ciências da Saúde, e de literatura cinzenta. População- pacientes adultos com úlcera venosa; Intervenção- Bota de Unna (BU); Controle- outras terapias compressivas (TC); Desfecho- cicatrização; Delineamentos- ensaio clínico randomizado, estudo de coorte e caso controle, publicados de 2002 a 2023. Avaliaramu-se efeito da intervenção, risco de viés e qualidade da evidência. Registrada no PROSPERO (CRD42021290077). Resultados: Foram incluídos 39 estudos, com 5.151 pacientes. A maioria (71,8%) era ensaios clínicos randomizados (ECR). A BU foi utilizada como intervenção/controle em oito estudos. Na comparação entre TC, somente 1 estudo com BU apresentou efeito superior (p < .001) na cicatrização, comparado com atadura elástica de alta compressão. Na análise de qualidade da evidência, 27 estudos foram avaliados com alto risco de viés. Conclusão: Não foi encontrada superioridade da BU na cicatrização de úlceras venosas quando comparada com outras TC.