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National Collaborating Centre for Nursing and Supportive Care (UK). The Use of Pressure-Relieving Devices (Beds, Mattresses and Overlays) for the Prevention of Pressure Ulcers in Primary and Secondary Care. London: Royal College of Nursing (UK); 2003 Oct. (NICE Clinical Guidelines, No. 7.)

  • This publication is provided for historical reference only and the information may be out of date.

This publication is provided for historical reference only and the information may be out of date.

Appendix 2General search strategies and databases searched

Costing and economic evaluations

#1(decubitus or pressure sore* or pressure ulcer* or bed?sore* or bed sore* or pressure damage or skin breakdown) in ti, ab, mesh
#2“Decubitus-Ulcer”/all subheadings
#3#1 and #2
#4mattress* or overlay* or pressure?relie* pressure relie* or air?support* or air support* or air?fluidi?ed or air fluidi?ed or support?surface* or support surface* or pressure?relieving or pressure relieving or low air loss bed*
#5(cost* or economic* or pric* or pricing or budget* or expenditure* or financ* or charge*) in ti, ab, mesh
#6#3 and #5
#7#4 and #5

Quality of life studies

#1(decubitus or pressure sore* or pressure ulcer* or bed sore* or bed?sore* or skin breakdown or pressure area*) in ti,ab,mesh
#2(quality near life) in ti,ab,mesh
#3(well being or well?being) near quality
#4(utility or utilities or rosser* or ihql or euro qol or euro?qol or eq?5d or 12d or 15d or qwb) in ti,ab,mesh
#5(12 or 15) near4 dimension*
#6(life near4 table*) in ti,ab,mesh
#7(health near related near quality) in ti,ab,mesh
#8(qol or ql or hrqol or hrql) in ti,ab,mesh
#9#2 or #3 or #4 or #5 or #6 or #7 or #8
#10#1 and #9
#2 to #9 also added to bedridden search on MEDLINE, Cinahl, Embase:
bed?rid* or bed ridden or bed?bound or bed bound or bed rest or bed?rest

Epidemiology studies

#1pressure sore* or decubitus or pressure area* or bed?sore* or bed sore* or pressure ulcer* or skin breakdown
#2epidemiol* or incidenc* or freq* or preval* or survey* or audit*

Note: These searches were adapted to each database.

Databases searched for costing/economic/quality of life/epidemiology studiesDate searched
BiomeNov 2001
TripAug 2001
EguidelinesAug 2001
National Guidelines ClearinghouseAug 2001
NZ Guidelines ClearinghouseAug 2001
Web of ScienceNov 2001
ISI Science and Technical Proceedings (via Web of Science)Nov 2001
Cochrane Library (reviews)Aug 2001
DARE – all databasesAug 2001
National Research RegisterSept 2001
Joanna BriggsAug 2001
ZETOCApril 2002
DatabaseCosting/economicEpidemiologyQOL/cost-utility
Dates searched1990 to Dec 20011980 to May 20021980 to Mar 2002
EconlitOct 19NRMar 2002
MEDLINEOct 17May 2002Mar 2002
EMBASEOct 2001May 2002Mar 2002
CINHALOct 2001May 2002Mar 2002
PSYCHLITOct 2001NRMar 2002
Cochrane Library Controlled Trialsvia Cochrane Wounds Group (CWG)
Current Controlled TrialsSept 2001NRCWG
British Nursing IndexOct 2001NRNR
HMICNov 2001May 2002Apr 2002
AMEDNov 2001NRApr 2002
Bio abstractsNov 2001May 2002NR
NHS EEDOct 2001NROct 2001
HEEDDec 2001NRDec 2001
ASSIANov 2001NRApr 2002
GLAMM (Quality of life assessment in medicine)NRNRApr 2001
Grey literature
Dissertation abstractsDec 2001Dec 2001Dec 2001
SigleNov 2001Nov 2001Nov 2001
Index to thesesDec 2001Dec 2001Dec 2001

Dates given are when the database was last searched.

NR indicates unlikely to obtain relevant material from this source.

Clinical effectiveness review (search strategies from the Cochrane Wounds Group)

The review was compiled using randomised controlled trials (RCTs) from the Cochrane Wounds Group specialist trials register. Multiple and repeated searches have been carried out since 1995, and our searching has, to some extent, been validated by searches carried out by BMJ Publishing Ltd for the Clinical Evidence publication. It is not possible at this stage to present a flow chart describing search yields and exclusions as the search has been ongoing for so many years, and initially was part of a larger search covering eight related wound management topics. The Cochrane Wounds Group specialist trials register was searched up to October 2002 and has been assembled and maintained as described below.

Electronic searches

1. MEDLINE search strategy

MEDLINE (Silver Platter version 4.0) was searched for RCTs and controlled clinical trials (CCTs) from 1966 to December 1997 using a mixture of free text terms and MeSH headings; from January 1998 it has been unnecessary to search MEDLINE as this is searched centrally by the UK Cochrane Centre for all trials and the results are transferred to Central/CCTR. Since January 1998, Central/CDSR has been searched instead of MEDLINE for all issues of the Cochrane Library.

The MEDLINE (Silver Platter version 4.0) search strategy used was as follows:

  1. decubitus ulcer/or foot ulcer/
  2. leg ulcer/or varicose ulcer/
  3. pilonidal cyst/
  4. skin ulcer/
  5. diabetic foot/
  6. ((plantar or diabetic or heel or venous or stasis or arterial) adj ulcer$).tw.
  7. ((decubitus or foot or diabetic or ischaemic or pressure) adj ulcer$).tw.
  8. ((pressure or bed) adj sore$).tw.
  9. ((pilonidal adj cyst) or (pilonidal adj sinus) or bedsore$).tw.
  10. ((diabetic adj foot) or (cavity adj wound)).tw.
  11. ((varicose or leg or skin) adj ulcer$).tw.
  12. (decubitus or (chronic adj wound$)).tw.
  13. ((sinus adj wound$) or (cavity adj wound$)).tw.
  14. or/1–13
  15. debridement/or biological dressings/or bandages/
  16. occlusive dressings/or clothing/or wound healing/
  17. antibiotics/or growth substances/or platelet-derived growth factor/
  18. fibroblast growth factor/or electrical stimulation therapy .ti,ab,sh.
  19. lasers/or nutrition/or surgery/or surgery, plastic/
  20. surgical flaps/or skin transplantations/or homeopathy/or homeopathic/
  21. acupuncture therapy/or acupuncture/or alternative medicine/
  22. alternative medicine/or massage/or iloprost/or alginates/
  23. zinc/or zinc oxide/or ointments/or anti-infective agents/
  24. dermatologic agents/or colloids/or cushions/or wheelchairs/
  25. beds/or wound dressings/
  26. (debridement or dressing$ or compress$ or cream$ or (growth adj factor$)).tw.
  27. (pressure-relie$ or (recombinant adj protein$) or bandag$ or stocking$).tw.
  28. (antibiotic$ or (electric adj therapy) or laser$ or nutrition$ or surg$).tw.
  29. (homeopath$ or acupuncture or massage or reflexology or ultrasound).tw.
  30. (iloprost or alginate$ or zinc or paste$ or ointment$ or hydrocolloid$).tw.
  31. ((compression adj therapy) or (compression adj bandag$) or wrap$).tw.
  32. (bed$ or mattress$ or wheelchair$ or (wheel adj chair) or cushion$).tw.
  33. ((wound adj dressing$) or vitamin$ or bind$ or gauze$ or heals or healing).tw.
  34. (diet or lotion$ or infect$ or reduc$ or (wound adj healing)).tw.
  35. (treat$ or prevent$ or epidemiol$ or aetiol$ or etiol$ or therap$ or prevalence or incidence).tw.
  36. or/15–35
  37. 14 and 36
  38. random allocation/or randomised controlled trials/
  39. controlled clinical trials/or clinical trials phase I/or clinical trials phase II/
  40. clinical trials phase III/or clinical trials phase IV/or clinical trials overviews/
  41. single-blind method/or double-blind method/
  42. publication bias/or review/or review, academic/
  43. review tutorial/or meta-analysis/or systematic review/
  44. ((random$ adj controlled adj trial$) or (prospective adj random$)).tw.
  45. ((random adj allocation) or random$ or (clinical adj trial$) or control$).tw.
  46. ((standard adj treatment) or compar$ or single-blind$ or double-blind$).tw.
  47. (blind$ or placebo$ or systematic$ or (systematic adj review)).tw.
  48. (randomised controlled trial or clinical trial).pt. or comparative study.sh.
  49. or/38–48
  50. 37 and 49
  51. limit 50 to human
  52. burns/or wounds, gunshot/or corneal ulcer/or exp dentistry/
  53. peptic ulcer/or duodenal ulcer/or stomach ulcer/
  54. ((peptic adj ulcer) or (duodenal adj ulcer) or traum$).tw.
  55. ((aortocaval adj fistula) or (arteriovenous adj fistula)).tw.
  56. (bite adj wound$).tw.
  57. or/52–56
  58. 51 not 57

2. Central/CDSR search strategy (on the Cochrane Library CD-ROM)

  1. ((DECUBITUS and ULCER*) or (VARICOSE and ULCER*))
  2. ((LEG or LEGS) and ULCER*)
  3. ((FOOT or FEET) and ULCER*)
  4. ((LEG or LEGS) and VARICOSE)
  5. (SKIN and ULCER*)
  6. SKIN-ULCER*:ME
  7. ((FOOT or FEET) and DIABETIC)
  8. ((((((PLANTAR or DIABETIC) or HEEL) or VENOUS) or STASIS) or ARTERIAL) and ULCER*)
  9. ((ISCHEMIC or PRESSURE) and ULCER*)
  10. ((BED or BEDS) near (SORE or SORES))
  11. (PRESSURE near (SORE or SORES))
  12. (PILONIDAL and CYST*)
  13. (PILONIDAL and SINUS*)
  14. (PILONIDAL and ABSCES*)
  15. ((WOUND or WOUNDS) and CAVITY)
  16. ((WOUND or WOUNDS) and SINUS*)
  17. ((WOUND or WOUNDS) and CHRONIC)
  18. ((WOUND or WOUNDS) and DECUBITUS)
  19. WOUND-INFECTION*:ME
  20. ((WOUND or WOUNDS) and MALIGNANT)
  21. WOUND-HEALING*:ME
  22. WOUNDS-GUNSHOT*:ME
  23. ((GUN or GUNS) or GUNSHOT)
  24. WOUNDS-STAB*:ME
  25. LACERATION*
  26. SURGICAL-WOUND-DEHISCENCE*:ME
  27. BITES-AND-STINGS*2:ME
  28. ((BITE or BITES) or BITING)
  29. TRAUMATOLOGY*:ME
  30. BURNS*:ME
  31. (WOUND* and BURN*)
  32. (BURN* or SCALD*)
  33. ((SITE or SITES) near DONOR)
  34. SELF-MUTILATION*:ME
  35. ((STAB or STABS) or STABBING)
  36. SOFT-TISSUE-INJURIES*:ME
  37. (((((((((((#1 or #2) or #3) or #4) or #5) or #6) or #7) or #8) or #9) or #10) or #11) or #12)
  38. (((((((((((#13 or #14) or #15) or #16) or #17) or #18) or #19) or #20) or #21) or #22) or #23) or #24)
  39. (((((((((((#25 or #26) or #27) or #28) or #29) or #30) or #31) or #32) or #33) or #34) or #35) or #36)
  40. (#37 or #38 OR #39)
  41. DENTAL
  42. (#40 not #41)
  43. CORNEAL
  44. (#42 not 43)
  45. DUODENAL-ULCER*1:ME
  46. (#44 not #45)
  47. CORNEAL-ULCER*1:ME
  48. (#46 not #47)
  49. CORNEAL-DISEASES*:ME
  50. (#48 not #49)
  51. ACNE
  52. (#50 not #51)
  53. BEDNET
  54. (#52 not #53)

3. CINAHL search strategy

CINAHL (Cumulative Index of Nursing and Allied Health Literature) was searched from inception to July 1999.

The CINAHL (Silver Platter version 4.0) search strategy used is as follows:

  1. (pressure-ulcer* or foot-ulcer* or leg-ulcer* or skin-ulcer*) in de
  2. (diabetic-foot* or diabetic-neuropathies*) in de
  3. ((diabetic-angiopathies*) in de) or diabetes-mellitus/complications/all age subheadings
  4. (pilonidal-cyst* or surgical-wound-infection*) in de
  5. (plantar or diabetic or heel or venous or stasis or (arterial near ulcer*)) in ti,ab
  6. (decubitus or foot or diabetic or ischaemic or (pressure near ulcer*)) in ti,ab
  7. (pressure or (bed near sore*))in ti,ab
  8. ((pilonidal near cyst ) or (pilonidal near sinus ) or bedsore) in ti,ab
  9. (diabetic near foot) or ((cavity near wound)in ti,ab)
  10. (varicose or leg or (skin near ulcer*)) in ti,ab
  11. ((decubitus or chronic) near wound*) in ti,ab
  12. (sinus near wound*) or ((cavity near wound*) in ti,ab)
  13. ((burn near wound*) or (gunshot near wound*) or (bite near wound*) or trauma) in ti,ab
  14. #1 or #2 or #3 or #4 or #5 or #6 or #7 or #8 or #9 or #10 or #11 or #12 or #13
  15. (clinical-trials or single-blind-studies or double-blind-studies) in de
  16. (control-group or placebos or meta-analysis) in de
  17. (random* near clinical near trial*) or ((prospective near random*) in ti,ab)
  18. ((random near allocation ) or random* or controlled-clinical-trial* or control) in ti,ab
  19. (comparison group* or (standard near treatment ) or compar* )in ti,ab
  20. (single-blind* or ( single near blind ) or double-blind or (double near blind)) in ti,ab
  21. (blind* or placebo* or systematic or ( systematic near review)) in ti,ab
  22. ((meta analysis or meta-analysis) or (trial* or prospective)) in ti,ab
  23. ((clinical-trials ) or (comparative-studies)) in de
  24. #15 or #16 or #17 or #18 or #19 or #20 or #21 or #22 or #23
  25. #14 and #24
  26. explode dentistry/all topical subheadings/all age subheadings
  27. (peptic-ulcer*) or (duodenal-ulcer*) or ((corneal-ulcer*)in de)
  28. (peptic near ulcer) or (duodenal near ulcer) or ((corneal near ulcer) in ti,ab)
  29. dentist* in de
  30. #26 or #27 or #28 or #29
  31. #25 not #30

Other databases that have been searched from the earliest date available until 1997 are:

EMBASE - Silver Platter version 4.0

ISI Science Citation Index (on BIDS)

BIOSIS (on EDINA)

British Diabetic Association database

CISCOM (complementary medicine database of the RCCM)

Conference proceedings (on BIDS)

Dissertation abstracts

RCN database (CD-ROM)

British Nursing Index (on ARC) to December 1998

Hand searches

Journals

The following specialist wound care journals were prospectively hand searched for all RCTs:

CARE: Science and Practice 1979–90 (later Journal of Tissue Viability – searched until present)

Decubitus, 1987 to 1993

Journal of Tissue Viability, 1991 to present

Journal of Wound Care, 1991 to present

Phlebology, 1986 to present.

Conference proceedings

Wound care conference proceedings that have been hand searched for RCTs:

Proceedings of the 1st European Conference on Advances in Wound Management, September 1991, Cardiff, UK

Proceedings of the 2nd European Conference on Advances in Wound Management, October 1992, Harrogate, UK

Proceedings of the 3rd European Conference on Advances in Wound Management, October 1993, Harrogate, UK

Proceedings of the 4th European Conference on Advances in Wound Management, September 1994, Copenhagen, Sweden

Proceedings of the 5th European Conference on Advances in Wound Management, November 1995, Harrogate, UK

Proceedings of the 6th European Conference on Advances in Wound Management, October 1996, Amsterdam, Netherlands

Proceedings of the 7th European Conference on Advances in Wound Management, November 1997, Harrogate, UK

Proceedings of the 8th European Conference on Advances in Wound Management, April 1998, Madrid, Spain

3rd Annual Symposium on Advanced Wound Care, March 1990, Orlando, USA

4th Annual Symposium on Advanced Wound Care, April 1991, San Francisco, USA

5th Annual Symposium on Advanced Wound Care, April 1992, New Orleans, USA

8th Annual Symposium on Advanced Wound Care & Medical Research Forum on Wound Repair, April 1995, San Diego, USA

9th Annual Symposium on Advanced Wound Care, April 1996, Atlanta, USA

Proceedings of: Going into the ‘90s: The Pharmacist and Wound Care, September 1992, London, UK

Proceedings of the Second Joint British/Swedish Angiology Meeting, 1991

Symposium on Venous Leg Ulcers, 1985

Venous Forum of the Royal Society of Medicine, 16th April 1999, Leeds

Other strategies

Efforts to identify unpublished studies

Several databases were searched, up to December 1997, to attempt to identify unpublished studies, including:

CRIB (current research in Britain)

DHS database

SIGLE

UK National Research Register

Experts in the field of wound care were contacted to enquire about relevant ongoing and recently published trials. In addition, manufacturers of wound care materials were contacted for details of any trials they are currently conducting.

Citations within obtained reviews and papers were scrutinised to identify additional studies.

Copyright © 2004, Royal College of Nursing.

All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means electronic,mechanical, photocopying, recording or otherwise,without prior permission of the Publishers or a licence permitting restricted copying issued by the Copyright Licensing Agency, 90 Tottenham Court Road, London W1T 4LP.This publication may not be lent, resold, hired out or otherwise disposed of by ways of trade in any form of binding or cover other than that in which it is published,without the prior consent of the Publishers.

Cover of The Use of Pressure-Relieving Devices (Beds, Mattresses and Overlays) for the Prevention of Pressure Ulcers in Primary and Secondary Care
The Use of Pressure-Relieving Devices (Beds, Mattresses and Overlays) for the Prevention of Pressure Ulcers in Primary and Secondary Care.
NICE Clinical Guidelines, No. 7.
National Collaborating Centre for Nursing and Supportive Care (UK).

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