This is the protocol for a review and there is no abstract. The objectives are as follows: To determine the effects on wound healing of a 'test and treat' strategy for diagnosing and treating high levels of wound protease activity in people with venous leg ulcers

Andriessen

Ashby

Augustin

Barrett

Bossuyt

Callam

Chang

Chin

Coleridge Smith

Cullen

Dumville

Ferrante di Ruffano

Fryback

Ghauri

Gohel

Graham

Guyatt

Hall

Harding KG

Herber

Higgins

Johnson

Jull

Kakagia

Kantor

Kontopantelis

Ladwig

Liberati

Lobmann

Lord

Madden

Margolis

McCarty

Moffatt

Mwaura

Nelzen

Nisi

Nwomeh

O'Meara

Parmar

Persoon

Ragnarson Tennvall

Rector

Serena

Serra

Sibbald

Snyder

Srinivasaiah

Thompson

Tierney

Trengove

Valencia

Veves

Vowden

Walker

Westby

Yager

Cochrane Database of Systematic Reviews

Gill Norman

Maggie J Westby

Nikki Stubbs

Jo C Dumville

Nicky Cullum

Crossref

A 'test and treat' strategy for elevated wound protease activity for healing in venous leg ulcers

Norman, Gill

Westby, Maggie J.

Stubbs, Nikki

Dumville, Jo C.

Cullum, Nicky

University of Queensland eSpace

A 'test and treat' strategy for elevated wound protease activity for healing in venous leg ulcers (Protocol)

BackgroundVenous leg ulcers are a common and recurring type of complex wound. They can be painful, malodorous, prone to infection and slow to heal. Standard treatment includes compression therapy and a dressing. The use of protease-modulating treatments for venous leg ulcers is increasing. These treatments are based on some evidence that a proportion of slow to heal ulcers have elevated protease activity in the wound. Point-of-care tests which aim to detect elevated protease activity are now available. A 'test and treat' strategy involves testing for elevated proteases and then using protease-modulating treatments in ulcers which show elevated protease levels.ObjectivesTo determine the effects on venous leg ulcer healing of a 'test and treat' strategy involving detection of high levels of wound protease activity and treatment with protease-modulating therapies, compared with alternative treatment strategies such as using the same treatment for all participants or using a different method of treatment selection.Search methodsWe searched the following electronic databases to identify reports of relevant randomised clinical trials: The Cochrane Wounds Group Specialised Register (January 2016), the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library) Issue 12, 2015); Ovid MEDLINE (1946 to January 2016); Ovid MEDLINE (In-Process & Other Non-Indexed Citations January 2016); Ovid EMBASE (1974 to January 2016); EBSCO CINAHL (1937 to January 2016). We also searched three clinical trials registers, reference lists and the websites of regulatory agencies. There were no restrictions with respect to language, date of publication or study setting.Selection criteriaPublished or unpublished RCTs which assessed a test and treat strategy for elevated protease activity in venous leg ulcers in adults compared with an alternative treatment strategy. The test and treat strategy needed to be the only systematic difference between the groups.Data collection and analysisTwo review authors independently performed study selection; we planned that two authors would also assess risk of bias and extract data.Main resultsWe did not identify any studies which met the inclusion criteria for this review. We identified one ongoing study; it was unclear whether this would be eligible for inclusion.Authors' conclusionsCurrently there is no randomised evidence on the impact of a test and treat policy for protease levels on outcomes in people with venous leg ulcers

A 'test and treat' strategy for elevated wound protease activity for healing in venous leg ulcers (Review)

BACKGROUND: Venous leg ulcers are a common and recurring type of complex wound. They can be painful, malodorous, prone to infection and slow to heal. Standard treatment includes compression therapy and a dressing. The use of protease-modulating treatments for venous leg ulcers is increasing. These treatments are based on some evidence that a proportion of slow to heal ulcers have elevated protease activity in the wound. Point-of-care tests which aim to detect elevated protease activity are now available. A 'test and treat' strategy involves testing for elevated proteases and then using protease-modulating treatments in ulcers which show elevated protease levels. OBJECTIVES: To determine the effects on venous leg ulcer healing of a 'test and treat' strategy involving detection of high levels of wound protease activity and treatment with protease-modulating therapies, compared with alternative treatment strategies such as using the same treatment for all participants or using a different method of treatment selection. SEARCH METHODS: We searched the following electronic databases to identify reports of relevant randomised clinical trials: The Cochrane Wounds Group Specialised Register (January 2016), the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library) Issue 12, 2015); Ovid MEDLINE (1946 to January 2016); Ovid MEDLINE (In-Process &amp; Other Non-Indexed Citations January 2016); Ovid EMBASE (1974 to January 2016); EBSCO CINAHL (1937 to January 2016). We also searched three clinical trials registers, reference lists and the websites of regulatory agencies. There were no restrictions with respect to language, date of publication or study setting. SELECTION CRITERIA: Published or unpublished RCTs which assessed a test and treat strategy for elevated protease activity in venous leg ulcers in adults compared with an alternative treatment strategy. The test and treat strategy needed to be the only systematic difference between the groups. DATA COLLECTION AND ANALYSIS: Two review authors independently performed study selection; we planned that two authors would also assess risk of bias and extract data. MAIN RESULTS: We did not identify any studies which met the inclusion criteria for this review. We identified one ongoing study; it was unclear whether this would be eligible for inclusion. AUTHORS' CONCLUSIONS: Currently there is no randomised evidence on the impact of a test and treat policy for protease levels on outcomes in people with venous leg ulcers

Norman, Gillian

Westby, Maggie

Dumville, Jo

The University of Manchester - Institutional Repository

English

A 'test and treat' strategy for elevated wound protease activity for healing in venous leg ulcers.

https://espace.library.uq.edu.au/view/UQ:370282/UQ370282_OA.pdf

A 'test and treat' strategy for elevated wound protease activity for healing in venous leg ulcers (Protocol)

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University of Queensland eSpace

University of Queensland eSpace

The University of Manchester - Institutional Repository