A Cochrane review [Abstract] 1 included 3 studies with a total of 169 subjects. No studies compared cleansing with no cleansing. Two studies compared different wound cleansing solutions: a statistically significant improvement in Pressure Sore Status Tool scores occurred for wounds cleansed with saline spray containing Aloe vera, silver chloride and decyl glucoside (Vulnopur) compared to isotonic saline (p = 0.025), but no statistically significant change in healing was seen when water was compared to saline (RR 3.00, 95% CI 0.21, 41.89). One study compared cleansing techniques; for pressure ulcers cleansed with pulsatile lavage, compared with sham (the lavage flow was directed into a wash basin positioned adjacent to the wound and not visible to the participants), there was a statistically significant reduction in ulcer volume at the end of the 3 week study period in the lavage group compared with the sham group (MD -6.60, 95% CI-11.23 to -1.97).
Comment: The quality of evidence is downgraded by imprecise results (limited study size for each comparison) and by limitations in study quality (inadequate or unclear allocation concealment).
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