Learning Objective 1: The learner will understand that many patients receive care that contradicts available convincing evidence, while another group of patients receive care that is contra-indicated.
Learning Objective 2: The learner will be able to explain that awareness and use of scientific evidence is essential for effective treatment choices in wound care.
METHODS This national survey in the Netherlands included doctors (e.g. (plastic) surgeons, dermatologists, and general practitioners), nurses, and specialized wound care nurses involved in wound care. We determined general awareness and use of evidence, based on (Cochrane) systematic reviews, for wound care products in open wounds and burns.
RESULTS We included 231 care providers. Doctors (n=88) preferred conventional antiseptics (e.g. iodine), while nurses favoured modern products (e.g. silver). Most groups (except plastic surgeons and specialized nurses) considered silver as an evidence-based antiseptic. Notably, silver-containing products were mostly used by specialized nurses (n=57) (47/57;82%), although only few of them (9/55;16%) thought using silver is evidence-based. For burns, silver-sulfadiazine, paraffin gauze, and hydrofibre were most popular among all groups. The majority of groups considered using silver-sulfadiazine to be evidence-based, although this contradicts scientific results. Awareness and use of the Cochrane Library was lower among nurses (n=86) than among doctors (p<0.001). Awareness was higher (p=0.001) among specialized nurses than among (home care) nurses.
CONCLUSIONS Present-day reality is that producing and disseminating systematic reviews with evidence-based recommendations for clinical practice do not result in more awareness and use of this evidence. The finding that wound care products are being used despite contradicting evidence endorses this statement. The present availability of compelling evidence and the generally positive attitude toward evidence-based practice should make evidence-based decision-making in wound care possible.
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