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Was ist evidenzbasiert in der Behandlung chronischer Wunden?

  • Chronische Wunden
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Zusammenfassung

Eine evidenzbasierte Datenlage zur Behandlung chronischer Wunden ist im Vergleich zur Fülle an gelisteten Publikationen über „wound healing“ (1990 bis heute: 48.247 Veröffentlichungen) nur in ausgesprochen geringem Umfang vorhanden und auch nur schwer zu finden. Zwar kann man in der Medline eine Anzahl von Treffern landen, doch muss dem Sucher bewusst sein, dass die Begrifflichkeit, nach der gesucht wird, in der Regel sehr willkürlich vom ursprünglichen Autor vergeben wurde. Schließlich sollen insbesondere die Keywords den Sucher auf eine Arbeit aufmerksam machen, die in den allermeisten Fällen nur ganz am Rande relevante Informationen in Bezug auf die eigentliche Thematik enthalten.

Ein interner Filter im Hinblick auf den Entstehungsmechanismus der publizierten Daten, der die Gewichtung der Arbeiten sicherlich erleichtern würde, ist nicht vorhanden, sodass z. B. unter den Begriffen „evidence-based medicine and chronic wound“ eine Arbeit erscheint, die als Grundlage ihrer Bewertung über die Anwendung von Honig bei chronischen Wunden Erwachsener „case studies and serial case studies“ angibt. So besteht neben dem Problem einer eher dünnen Datenlage zusätzlich die Schwierigkeit in einer angemessenen Zeit die tatsächlich relevanten Arbeiten aufzufinden, was in der Regel überhaupt nur bei einer sehr eng begrenzten Suchspezifikation gelingt.

Hier soll der Versuch gemacht werden, die unglaubliche Datenfülle im Hinblick auf die Behandlung chronischer Wunden in eine gewisse Systematik zu bringen und schließlich in groben Schlaglichtern einzelne Schwerpunkte etwas zu erhellen.

Abstract:

Very few evidence-based trials on the treatment of chronic wounds are available, in contrast to the total amount of listed papers on this topic (since 1990:48247). Using MEDLINE as a search tool for this topic one obtains some appropriate matches, but it is striking that the authors of the articles concerned have usually chosen a set of relatively idiosyncratic keywords. These words, used to narrow the search for publications, are meant to attract the reader’s attention, but in the majority of cases fail to do so because they only show a distant link, or are mentioned only in one short text passage. There is no existence of something like an “internal filter” showing the real character of an article or its genesis, which would make it easier to validate their significance. For instance, a search for the keywords “evidence-based medicine and chronic wound” turns up a paper that gives “case study” or “serial case study” as the foundation for its evaluation of the application of honey in treating chronic wounds in adults. Apart from the very sparse data, it appears to be a difficult task to efficiently find the appropriate relevant publications without an extremely narrow search strategy. In this article we attempt to systematize the incredible wealth of data on the treatment of chronic wounds and throw some light on particular major topics.

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Authors and Affiliations

  1. Klinik für Gefäßchirurgie, Knappschaftskrankenhaus Bottrop

    M. Voshege &  G. Wozniak

  2. Klinik für Gefäßchirurgie, Knappschaftskrankenhaus, Osterfelderstraße 157, 46242, Bottrop

    G. Wozniak

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  1. M. Voshege
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  2. G. Wozniak
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Correspondence to G. Wozniak.

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Voshege, M., Wozniak, G. Was ist evidenzbasiert in der Behandlung chronischer Wunden?. Gefässchirurgie 8, 269–276 (2003). https://doi.org/10.1007/s00772-003-0300-9

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  • DOI: https://doi.org/10.1007/s00772-003-0300-9

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