***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE To compare a hydrogel dressing with a conservative topical wound-care regimen ( gauze with povidone-iodine ) for the treatment of  pressure ulcers . METHOD A prospect i ve study comprising 27 ( 24 male and three female ) spinal-cord injury patients with a total of 49 pressure ulcers . Wounds were r and omised into a treatment group ( n=25 ) or control group ( n=24 ) . The primary outcome measure was the rate of wound healing ( cm2/days ) . RESULTS Healing rates in the treatment group were higher than in the control group , although this was not statistically significant . Some 84 % of the wounds in the treatment group and 54 % in the control group epithelialised , which was statistically significant ( p=0.04 ) . The mean healing time in the treatment group was 48 days compared with 45 days for the controls . CONCLUSION Our results suggest that hydrogel occlusive wound dressings facilitate healing by promoting more rapid epithelialisation of pressure ulcers , when compared with conservative wound care A new dressing for chronic wounds  , BioFilm hydrogel dressing , was compared to a hydrocolloid dressing ( HCD ) control in a clinical trial involving 90 patients and 129 Stage I and II wounds ( defined by Enis and Sarmienti ) . The testing sites included both acute care and extended care facilities . A comparison of healing response and functional characteristics of both dressings was part of this assessment . Biofilm dressings demonstrated a healing advantage over the HCD . In addition , clinicians judged that the hydrogel dressings were easier to use and had superior fluid management capability and product integrity with minimal disruption to the healing wounds Pressure ulcers are common among elderly nursing home residents . To be effective in managing these wounds , a dressing should maintain a moist environment , facilitate healing , absorb exu date , remain in place for a number of days , and prevent trauma to the surrounding skin . An 8-week , open , r and omized , multicenter , controlled study was conducted to compare the effects of a new self-adherent soft silicone dressing and a self-adherent hydropolymer dressing on Stage II pressure ulcers . Thirty-eight ( 38 ) residents participated in the study . Eighteen residents ( mean age 83.8 years , range 74.9 to 95.1 years ) were r and omized to wound management with a soft silicone dressing , and the ulcers of 20 residents ( mean age 82.5 years , range 66.4 to 91.9 years ) were managed with a hydropolymer dressing .  Wound healing , wound and surrounding skin characteristics , and ease of dressing removal were measured and documented . During the study , eight ( 44 % ) ulcers in the soft silicone group and 10 ( 50 % ) in the hydropolymer dressing group healed . Both dressings were changed approximately once a week and no differences in signs of inflammation , amount of exu date and odor , or incidence of leakage were observed . Damage to the surrounding skin , maceration , and dressing removal difficulties were less common with the soft silicone dressing . Differences in tissue damage between the two dressings were significant during weeks 1 , 2 , and 3 ( P < 0.05 ) . Studies with a larger sample size are needed to confirm these findings Objectives To evaluate if ‘ wrap therapy ’ using food wraps , which is widely used in Japanese clinical sites , is not inferior when compared to guideline adhesion treatments . Design Multicentre , prospect i ve , r and omised , open , blinded endpoint clinical trial . Setting 15 hospitals in Japan . Patients 66 older patients with new National Pressure Ulcer Advisory Panel stage II or III pressure ulcers . Interventions Of these 66 patients , 31 were divided into the conventional treatment guidelines group and 35 into the wrap therapy group . Main outcome measures The primary end point was the period until the pressure ulcers were cured . The secondary end point was a comparison of the speed of change in the Pressure Ulcer Scale for Healing score . Results 64 of the 66 patients were analysed . The estimated mean period until healing was 57.5 days ( 95 % CI 45.2 to 69.8 ) in the control group as opposed to 59.8 days ( 95 % CI 49.7 to 69.9 ) in the wrap therapy group . By the extent of pressure ulcer infiltration , the mean period until healing was 16.0 days ( 95 % CI 8.1 to 23.9 ) in the control group as opposed to 18.8 days ( 95 % CI 10.3 to 27.2 ) in the wrap therapy group with National Pressure Ulcer Advisory Panel stage II ulcers , and 71.8 days ( 95 % CI 61.4 to 82.3 ) as opposed to 63.2 days ( 95 % CI 53.0 to 73.4 ) , respectively , with stage III ulcers . There is no statistical significance in difference in Pressure Ulcer Scale for Healing scores . Conclusions It might be possible to consider wrap therapy as an alternative choice in primary care setting s as a simple and inexpensive dressing care . Clinical Trial registration UMIN Clinical Trials Registry UMIN000002658 . Summary protocol is available on https://upload.umin.ac.jp/cgi-bin/ctr/ctr.cgi?function=brows&action=brows&type=detail&recptno=R000003235&admin=0 & language = Background There are many barriers to patient participation in r and omised controlled trials of cancer treatments . To increase participation in trials , strategies need to be identified to overcome these barriers . Our aim was to assess the effectiveness of interventions to overcome barriers to patient participation in  r and omised controlled trials ( RCTs ) of cancer treatments . Methods A systematic review was conducted . Published and unpublished studies in any language were search ed for in fifteen electronic data bases , including MEDLINE , EMBASE , CINAHL and PsycINFO , from inception to the end of 2004 . Studies of any interventions to improve  cancer patient participation  in RCTs , which reported the change in recruitment rates , were eligible for inclusion . RCTs and non-r and omised controlled trials as well as before and after studies reporting baseline rates specific to the population being investigated were included . Data were extracted by one review er into structured summary tables and checked for accuracy by a second review er . Each included study was assessed against a checklist for method ological quality by one review er and checked by a second review er . A narrative synthesis was conducted . Results Eight studies were identified that met the inclusion criteria : three RCTs , two non-r and omised controlled trials and three observational studies . Six of the studies had an intervention that had some relevance to the UK . There was no robust evidence that any of the interventions investigated led to an increase in  cancer patient participation in RCTs , though one good quality RCT found that urologists and nurses were equally effective at recruiting participants to a treatment trial for prostate cancer . Although there was no evidence of an effect in any of the studies , the evidence was not of sufficient quality to be able to conclude that these interventions therefore do not work . Conclusion There is not a strong evidence -base for interventions that increase  cancer patient participation  in r and omised trials . Further research is required to evaluate the effectiveness of strategies to increase participation in cancer treatment trials This study compared the efficacy of two hydrogel dressings in the debridement of  necrotic pressure sores .  This r and omised , controlled , assessor-blind , clinical trial involved 50 patients whose wounds were assessed weekly using computerised wound analysis for four weeks or until debrided . Debridement was identified when there was 80 % red granulation tissue present and no sign of necrosis . There were no statistically significant differences in comfort , wound odour , surrounding skin condition or time to debridement between the two groups BACKGROUND There have been no studies that have tested the Braden Scale for predictive validity and established cutoff points for assessing risk specific to different setting s. OBJECTIVES To evaluate the predictive validity of the  Braden Scale  in a variety of setting s ( tertiary care hospitals , Veterans Administration Medical Centers [ VAMCs ] , and skilled nursing facilities [ SNFs ] ) . To determine the critical cutoff point for classifying risk in these setting s and whether this cutoff point differs between setting s. To determine the optimal timing for assessing risk across setting s. METHOD R and omly selected subjects ( N= 843 ) older than 19 years of age from a variety of care setting s who did not have pressure ulcers on admission were included . Subjects were 63 % men , 79 % Caucasian , and had a mean age of 63 ( + /-16 ) years . Subjects were assessed for  pressure ulcers  using the  Braden Scale  every 48 to 72 hours for 1 to 4 weeks . The  Braden Scale score and skin assessment  were independently rated , and the data collectors were blind to the findings of the other measures . RESULTS One hundred eight of 843 ( 12.8 % ) subjects developed pressure ulcers . The incidence was 8.5 % , 7.4 % , and 23.9 % in tertiary care hospitals , VAMCs , and SNFs , respectively . Subjects who developed pressure ulcers were older and more likely to be female than those who did not develop ulcers . Braden Scale scores were significantly ( p = .0001 ) lower in those who developed ulcers than in those who did not develop ulcers . Overall , the critical cutoff score for predicting risk was 18 . Risk assessment on admission is highly predictive of pressure ulcer development in all setting s but not as predictive as the assessment completed 48 to 72 hours after admission . CONCLUSIONS Risk assessment on admission is important for timely planning of preventive strategies . Ongoing assessment in SNFs and VAMCs improves prediction and permits fine-tuning of the risk-based prevention protocol s. In tertiary care the most accurate prediction occurs at 48 to 72 hours after admission and at this time the care plan can be refined The management of pressure sores in community setting s , poses a clinical problem which challenges the patient ’s tolerance and the clinician ’s diligence and ingenuity .  Pressure sores can be painful , lead to infection and are associated with considerable morbidity and increased mortality ( Patterson & Bennett , 1995:919 ; Bale , Banks , Hagelstein & Harding , 1998:65 ) . Treatment costs of these wounds are high in terms of re sources ( Colin 1995:65 ; Wood , Griffiths & Stoner , 1997:256 ) . However , since there are untold cost in terms of pain and suffering to the patient , it is impossible to calculate the true cost of pressure sores ( Dealey , 1994:87 ) A total of 67 patients with pressure ulcers were r and omized into one of three treatment modalities : hydrogel sheet dressing , hydrocolloid , or wet-to-moist gauze .  Safety , efficacy , and physical attributes of the three dressings were evaluated . No statistical significance was found in wound healing rate among the three treatments . Hydrogel sheets were advantageous in allowing wound visualization without dressing or wound disruption UNLABELLED ﻿﻿﻿﻿﻿﻿ The role of maintenance debridement in wound healing has been well described , yet little is known regarding comparative methods and associated outcomes with this process when using collagenase or hydrogel . OBJECTIVE Evaluation of maintenance debridement and wound closure with collagenase compared to hydrogel in institutionalized adults with pressure ulcers from time of necrotic tissue removal up to 84 days from enrollment . METHODS This second phase of a rollover evaluation enrolled only subjects who successfully completed phase 1 ( previously reported ) from time of necrotic tissue debridement . Subjects received daily dressing changes with either hydrogel or collagenase followed by a st and ard semiocclusive dressing to evaluate wound-healing parameters and wound closure from initial enrollment to day 84 . Investigators blinded to r and omization evaluated weekly wound photographs using a digital planimetry software package for wound-healing parameters . Additionally , Pressure Ulcer Scale for Healing ( PUSH ) © Tool and wound bed scores ( WBS ) were monitored . RESULTS Eleven of 13 subjects from the collagenase group entered into phase 2 , with 4 of the 14 subjects from the hydrogel group . One subject from each group was eliminated within the first week of phase 2 . All subjects ( n = 3 ) in the hydrogel group reached complete epithelialization with a mean of 32.6 days . Nine of 10 subjects in the collagenase group reached completed epithelialization with a mean of 45 days . An independent sample s t test showed no statistical significance between the 2 groups ( P = 0.121 ) in days to healing . A Fisher 's exact test performed on the primary endpoint of complete epithelialization also demonstrated no significant difference in outcomes between the groups ( P = 0.99 ) . Mean WBS at the onsetof phase 2 was 13.7 ( range 12 - 16 ) , and the PUSH Tool mean score was 1.0 ( range 0 - 3 ) . In aggregating phase 1 and phase 2 data , a difference in the closure rates at the end of the study , 69 % ( collagenase ) vs 21 % ( hydrogel ) , was statically significant ( P = 0.0213 ) using a Fisher 's exact test . CONCLUSION Facilitating maintenance debridement by either collagenase or hydrogel can be used to complete wound closure when used in conjunction with a vali date d predictive wound-healing tool that closely monitors therapy . This study showed statistical significance in favor of collagenase when evaluating closure rates from the onset of the pressure ulcer . UNLABELLED 
    Output:
    
Where data were available there was no evidence of a difference between hydrogel and alternative treatments in terms of complete wound healing or adverse events .