***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 assess the effect of a plaster cast socket on the healing of open wounds and on temporary  prosthesis fitting  after below-knee amputation because of arterial occlusive disease . DESIGN R and omized controlled trial . SETTING Rehabilitation center , university hospital . PATIENTS All included patients had undergone recent ( in the previous 3 months ) below-knee amputation because of arterial disease and initially had an open stump . Patients were r and omly assigned to two groups of 28 subjects each . The sizes of the amputation scars were 8 to 24 cm2 . Ischemia of the stump was eliminated as a probable cause of delayed wound healing by the inclusion criterion of transcutaneous oxygen tension ( TcPO2 ) of > 35 mmHg . The average age in group I ( the experimental group ) was 65.2 + /- 12.4 ( SD ) years and in group II ( the control group ) 66.8 + /- 10.8 years ( not significant ) . INTERVENTION A plaster cast ( supracondylar-type ) socket was fitted on the stumps of group I patients , interposed with a silicone sleeve . The patients were gradually trained to wear this cast for up to 5 hours a day . They were provided with elastic compression b and ages for the remainder of the time . Patients in group II wore elastic compression b and ages , which were only removed for dressing changes . MAIN OUTCOME MEASURES Time required for stump healing , length of time between amputation and ability to walk wearing a contact socket , and length of hospital stay . RESULTS Group I had a quicker average healing time ( 71.2 + /- 31.7 [ SD ] days compared to the control group 's 96.8 + /- 54.9 days ) and a shorter average length of hospital stay ( 99.8 + /- 22.4 days compared to the control group 's 129.9 + /- 48.3 days ) . CONCLUSION Use of a plaster cast socket leads to more rapid healing of the open stump and to a shorter hospitalization . If there is no stump ischemia , this plaster cast technique is safe To comprehend the results of a r and omised controlled trial ( RCT ) , readers must underst and its design , conduct , analysis , and interpretation . That goal can be achieved only through total transparency from authors . Despite several decades of educational efforts , the reporting of RCTs needs improvement . Investigators and editors developed the original CONSORT ( Consoli date d St and ards of Reporting Trials ) statement to help authors improve reporting by use of a checklist and flow diagram . The revised CONSORT statement presented here incorporates new evidence and addresses some criticisms of the original statement . The checklist items pertain to the content of the Title , Abstract , Introduction , Methods , Results , and Discussion . The revised checklist includes 22 items selected because empirical evidence indicates that not reporting this information is associated with biased estimates of treatment effect , or because the information is essential to judge the reliability or relevance of the findings . We intended the flow diagram to depict the passage of participants through an RCT . The revised flow diagram depicts information from four stages of a trial ( enrolment , intervention allocation , follow- up , and analysis ) . The diagram explicitly shows the number of participants , for each intervention group , included in the primary data analysis . Inclusion of these numbers allows the reader to judge whether the authors have done an intention- to-treat analysis . In sum , the CONSORT statement is intended to improve the reporting of an RCT , enabling readers to underst and a trial 's conduct and to assess the validity of its results findings of impaired activity of aryl hydrocarbon hydroxylase in the liver and small bowel of patients with psoriasis . ' The salivary clearances indicate that the inducing effect of smoking on antipyrine metabolism is similar in patients and normal subjects . This contrasts with our observations in skin : so far we have been unable to show any difference in skin activity of aryl hydrocarbon hydroxylase between smokers and non-smokers , and in-vitro induction with benzanthracene of aryl hydrocarbon hydroxylase activity in lesion-free skin of patients with psoriasis is only about 50 % of normal . ' Clearly , in-vivo induction by smoking as measured by antipyrine clearance is not analogous to in-vitro induction by benzanthracene as measured by activity of aryl In this r and omised prospect i ve parallel-group controlled study , a modern cellulose-based fibre dressing was compared with a traditional ribbon gauze and proflavine dressing , used intra- and post-operatively . The study evaluates each treatment for the reduction in pain , improvement in the quality of treatment and patient satisfaction .  Forty patients , with wounds left to heal by secondary intention , were studied . The results show several significant advantages for the cellulose-based fibre dressing .  Pain levels on removal at the first dressing change were significantly reduced in the cellulose-based fibre dressing group ( p = 0.002 ) ; the ribbon gauze patients routinely required analgesia before removal of the first dressing . At one week , a significantly greater number of patients in the cellulose-based fibre dressing group stated that they would be happy to have their first dressing change carried out at home without analgesia compared to the ribbon gauze group . This would enable patients to be discharged earlier and could represent a considerable financial saving to the hospital A report of a study that examined some clinical characteristics of two commonly used wound PURPOSE The purpose of this study was to investigate the efficacy and safety of recombinant human platelet-derived growth factor ( rhPDGF-BB ) in a double-blind , placebo-controlled , multicenter study of patients with chronic diabetic ulcers . METHODS Patients with chronic , full-thickness , lower-extremity diabetic neurotrophic ulcers of at least 8 weeks ' duration , free of necrotic and infected tissue after debridement , and with transcutaneous oxygen tensions of 30 mm Hg or greater were studied . A total of 118 patients were r and omized to receive either topical rhPDGF-BB ( 2.2 micrograms/cm2 of ulcer area ) or placebo until the ulcer was completely resurfaced or for a maximum of 20 weeks , whichever occurred first . RESULTS Twenty-nine ( 48 % ) of 61 patients r and omized to the rhPDGF-BB group achieved complete wound healing during the study compared with only 14 ( 25 % ) of 57 patients r and omized to the placebo group ( p = 0.01 ) . The median reduction in wound area in the group given rhPDGF-BB was 98.8 % compared with 82.1 % in the group given placebo ( p = 0.09 ) . There were no significant differences in the incidence or severity of adverse events between the rhPDGF-BB and placebo groups . CONCLUSIONS Once-daily topical application of rhPDGF-BB is safe and effective in stimulating the healing of chronic , full-thickness , lower-extremity diabetic neurotrophic ulcers This prospect i ve r and omised trial compared the performance of three dressing protocol s in the management of 36 dehisced surgical abdominal wounds :  a st and ard alginate ; a gauze moistened with sodium hypochlorite ( 0.05 % ) ; and a combine dressing pad . Outcomes assessed were : healing time ( cm2 per day and cm3 per day ) , patient comfort ( pain and satisfaction ) and cost . There were no statistically significant differences in healing rates between the three groups but there was a trend for the combine dressing pad protocol to produce a greater reduction in wound area . The combine dressing pad protocol performed well when compared with the calcium alginate in terms of healing time , patient comfort and cost . Maximum pain was significantly greater ( p = 0.011 ) and satisfaction significantly lower among patients who received the sodium hypochlorite protocol . Costs during the in-patient phase were also substantially higher for the sodium hypochlorite protocol . Trial results support the view that sodium hypochlorite dressing protocol s for surgical wounds should be ab and oned This trial was undertaken to examine the safety and efficacy of four-layer compared with short stretch compression b and ages for the treatment of venous leg ulcers within the confines of a prospect i ve , r and omised , ethically approved trial . Fifty-three patients were recruited from a dedicated venous ulcer assessment clinic and their individual ulcerated limbs were r and omised to receive either a four-layer b and age (FLB)(n = 32 ) or a short stretch b and age (SSB)(n = 32 ) . The endpoint was a completely healed ulcer . However , if after 12 weeks of compression therapy no healing had been achieved , that limb was withdrawn from the study and deemed to have failed to heal with the prescribed b and age . Leg volume was measured using the multiple disc model at the first b and aging visit , 4 weeks later , and on ulcer healing . Complications arising during the study were recorded . Data from all limbs were analysed on an intention to treat basis ; thus the three limbs not completing the protocol were included in the analysis . Of the 53 patients , 50 completed the protocol . At 1 year the healing rate was FLB 55 % and SSB 57 % ( chi 2 = 0.0 , df = 1 , P = 1.0 ) . Limbs in the FLB arm of the study sustained one minor complication , whereas SSB limbs sustained four significant complications . Leg volumes reduced significantly after 4 weeks of compression , but subsequent volume changes were insignificant . Ulcer healing rates were not influenced by the presence of deep venous reflux , post-thrombotic deep vein changes nor by ulcer duration . Although larger ulcers took longer to heal , the overall healing rates for large ( > 10 cm2 ) and small ( 10 cm2 or less ) ulcers were comparable . Four-layer and short stretch b and ages were equally efficacious in healing venous ulcers independent of pattern of venous reflux , ulcer area or duration . FLB limbs sustained fewer complications than SSB The treatment of established hidradenitis suppurativa dem and s complete excision of the apocrine gl  and s in the affected area . Ten patients undergoing bilateral excision of the axillary skin , had one axilla grafted and the other allowed to heal by granulation utilising Silastic foam dressing , in order to compare the two methods . Split skin grafting result ed in more rapid healing of the excised area than healing by secondary intention . However , Silastic foam dressing result ed in certain healing with a good cosmetic result and avoided the need for immobilisation and a painful donor site . Most patients in this series preferred Silastic foam dressing to skin grafting After nail matrix ablation using phenolization , a medicated wound dressing ( 10 % povidone iodine ) , an amorphous hydrogel dressing ( Intrasite Gel ) , and a control dressing ( paraffin gauze ) were evaluated . Forty-two participants , r and omly divided into three dressing groups , were evaluated . Healing time did not differ between the 10 % povidone iodine ( 33 days ) , amorphous hydrogel ( 33 days ) , and the control dressing ( 34 days ) . For all groups , the clinical infection rate was lower than in previous studies , and there was no clinical difference between groups ( one infection in the povidone iodine and control groups ; none in the amorphous hydrogel group ) . However , in the amorphous hydrogel group , other complications , such as hypergranulation , were more likely . This investigation indicated that medicated or hydrogel dressings did not enhance the rate of healing or decrease infection rates Calcium alginate dressings have been used in the treatment of  pressure ulcers and leg ulcers .  This study analyzes the effectiveness of a calcium alginate dressing in wound exu date absorption , patient comfort , and ease of application OBJECTIVE We assessed in a r and omized prospect i ve trial the effectiveness of Graftskin , a living skin equivalent , in treating noninfected nonischemic chronic plantar diabetic foot ulcers . RESEARCH DESIGN AND METHODS In 24 centers in the U.S. , 208 patients were r and omly assigned to ulcer treatment either with Graftskin ( 112 patients ) or saline-moistened gauze ( 96 patients , control group ) .  St and ard state-of-the-art adjunctive therapy , which included extensive surgical debridement and adequate foot off-loading , was provided in both groups . Graftskin was applied at the beginning of the study and weekly thereafter for a maximum of 4 weeks ( maximum of five applications ) or earlier if complete healing occurred . The major outcome of complete wound healing was assessed by intention to treat at the 12-week follow-up visit . RESULTS At the 12-week follow-up visit , 63 ( 56 % ) Graftskin-treated patients achieved complete wound healing compared with 36 ( 38 % ) in the control group ( P = 0.0042 ) . The Kaplan-Meier median time to complete closure was 65 days for Graftskin , significantly lower than the 90 days observed in the control group ( P = 0.0026 ) . The odds ratio for complete healing for a Graftskin-treated ulcer compared with a control-treated ulcer was 2.14 ( 95 % CI 1.23 - 3.74 ) . The rate of adverse reactions was similar between the two groups with the exception of osteomyelitis and lower-limb amputations , both of which were less frequent in the Graftskin group . CONCLUSIONS Application of Graftskin for a maximum of 4 weeks results in a higher healing rate when compared with state-of-the-art currently available treatment and is not associated with any significant side effects . Graftskin may be a very useful adjunct for the management of diabetic foot ulcers that are resistant to the currently available st and ard of care Many conventional dressings are painful when removed , and may be detrimental to healing . In 
    Output:
    
REVIEW ERS ' CONCLUSIONS We found only small , poor quality trials ; the evidence is therefore insufficient to determine whether the choice of dressing or topical agent affects the healing of surgical wounds healing by secondary intention .
Foam is best studied as an alternative for gauze and appears to be preferable as to pain reduction , patient satisfaction and nursing time