Summary of findings for the main comparison. Fatty acid versus other topical intervention or standard care for preventing pressure ulcers.
| Fatty acid versus other topical intervention or standard care for preventing pressure ulcers | ||||||
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Patient or population: individuals at risk of pressure ulcer development
Settings: nursing homes (3 trials); orthopaedic unit (1 trial); high‐dependency unit (1 trial)
Intervention: fatty acid Comparison: other topical intervention or standard care | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of participants (trials) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Other topical intervention or standard care | Fatty acid | |||||
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Pressure ulcer incidence: fatty acid vs olive oil Assessed with observation Follow‐up: range unknown, 16 weeks |
Study population | RR 1.28 (0.76 to 2.17) | 1060 (2 RCTs) | ⊕⊕⊝⊝ Low1 | There was no clear difference in pressure ulcer incidence (29/511 (6%) fatty acid, vs 24/549 (4%) olive oil; low‐certainty evidence) | |
| 44 per 1000 | 56 per 1000 (33 to 95) | |||||
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Pressure ulcer incidence: fatty acid vs control compound Assessed with observation Follow‐up: 30 days |
Study population | RR 0.42 (0.22 to 0.80) | 331 (1 RCT) | ⊕⊕⊝⊝ Low2 | Fatty acid may reduce pressure ulcer incidence (12/164 (7.3%) fatty acid, vs 29/167 (17.4%) control; low‐certainty evidence) | |
| 174 per 1000 | 73 per 1000 (38 to 139) | |||||
|
Pressure ulcer incidence: fatty acid vs standard care Assessed with observation Follow‐up: range unknown, 30 days |
Study population | RR 0.70 (0.41 to 1.18) | 187 (2 RCTs) | ⊕⊕⊝⊝ Low3 | There was no clear difference in pressure ulcer incidence (18/93 (19%) fatty acid, vs 26/94 (28%) standard care; low‐certainty evidence) | |
| 277 per 1000 | 194 per 1000 (113 to 326) | |||||
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Pressure ulcer incidence: fatty acid vs olive oil (high‐quality trials) |
Study population | RR 1.46 (0.77 to 2.75) | 831 (1 RCT) | ⊕⊕⊝⊝ Low4 | There was no clear difference in pressure ulcer incidence (fatty acid: 21/394 (5.3%) fatty acid, vs 16/437 (3.7%) olive oil; low‐certainty evidence) | |
| 37 per 1000 | 53 per 1000 (28 to 101) | |||||
| Adverse event: fatty acid vs olive oil | Study population | RR 2.22 (0.20 to 24.37) | 831 (1 RCT) | ⊕⊕⊝⊝ Low5 | There was no clear difference in adverse events (itching or redness); (fatty acid 2/294 (0.007%), vs 1/437 (0.002%) olive oil; low‐certainty evidence) | |
| 2 per 1000 | 5 per 1000 (0 to 56) | |||||
| *The basis for the assumed risk (e.g. the median control group risk across trials) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; RCT: randomised controlled trial; RR: risk ratio | ||||||
| GRADE Working Group grades of evidence High certainty: we are very confident that the true effect lies close to that of the estimate of the effect. Moderate certainty: we are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low certainty: our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect. Very low certainty: we have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect. | ||||||
1Downgraded twice for imprecision due to the small number of events and the wide confidence interval. 2Downgraded once for high risk for attrition bias and downgraded once for serious imprecision due to the small number of events. 3Downgraded once for high risk of performance bias and downgraded once for serious imprecision due to a wide confidence interval. 4Downgraded twice for imprecision due small number of events leading to a wide confidence interval. 5Downgraded twice for very serious imprecision due to a very wide confidence interval and very small number of events.