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Meta-Analysis
. 2024 Sep 2:58:e20230397.
doi: 10.1590/1980-220X-REEUSP-2023-0397en. eCollection 2024.

Effect of Unna's boot on venous ulcer healing: a systematic review and meta-analysis

[Article in English, Portuguese]
Fernanda Peixoto Cordova  1 , Ana Claudia Furhmann  1 , Andreia Cristina Feitosa do Carmo  2 , Eduardo Nunes Vales  1 , Diego Henrique Terra  3 , Bárbara Uuritz da Silva  4 , Diani de Oliveira Machado  5 , Amália de Fátima Lucena  1 , Lisiane Manganelli Girardi Paskulin  1
Affiliations
Meta-Analysis

Effect of Unna's boot on venous ulcer healing: a systematic review and meta-analysis

[Article in English, Portuguese]
Fernanda Peixoto Cordova et al. Rev Esc Enferm USP. .

Abstract
in English, Spanish

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.

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.

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Figures

Figure 1
Figure 1. Flowchart of articles selection according to PRISMA 2020.
Figure 2
Figure 2. Assessment of risk of bias of RCT with intention-to-treat analysis.
Figure 3
Figure 3. Meta-analysis of the number of healed ulcers compared among compression therapy groups.
Figura 1
Figura 1. Fluxograma seleção de artigos de acordo com PRISMA 2020.
Figura 2
Figura 2. Avaliação do risco de viés de ECR com análise por intenção de tratar.
Figura 3
Figura 3. Metanálise do número de úlceras cicatrizadas comparado entre grupos de terapias compressivas.
See this image and copyright information in PMC

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