Randomized Clinical Trial of Hydrofiber Dressing

Critical Appraisal: Randomized Clinical Trial of Hydrofiber Dressing with Silver Versus Povidine-Iodine Gauze in the Management of Open Surgical and Traumatic Wounds.
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Introduction
According to the Willey Online Library (2014), the international wound journal is among the top 20 journals in dermatology with an impact factor of 2.023. Additionally, the journal ranks 66th out of 202 surgical journals. The journal also scored an A in the Australian Era rankings. This reveals that the international wound journal, published in England, is a high-ranking journal. It is also notable that the researchers are qualified health practitioners. For instance, the lead researcher Jurzak is a surgeon who specializes in thyroid and endocrine surgery, proctology, vein surgery, visceral surgery and digestive surgery. Hence, this publication could be used for evidence-based practice.
Background of the Problem
Jurczak et al, (2007) developed a background of their study because it enabled the researchers to attack the research problem objectively (Hickson, 2008). This owes to the reality that Gauze dressings are used for open surgical wounds, which are always left to restore by secondary intent. This despises the fact that removal of gauze dressings could tamper with the newly formed epidermis. Thus, the removal could result in tissue injury, pain, and exposure of the wound. The use of Gauze dressings is also limited by its capacity to handle wound exudate because it provides little protection from infection to the wound. Consequently, Gauze dressing is often soaked in povidone-iodine before dressing. Nonetheless, the combination is associated with chemical burns, particularly with irritation, prolonged exposure, and maceration. It is notable thatan extreme reaction to povidone-iodine could result in ulceration.
The authors hypothesized that using Hydrofiber Ag dressing would be easy to use, would reduce pain, improve exudate handling, improve patient comfort, and promote wound healing. As a result, the authors used the following research question: Does the use of Povidone-iodine gauze and Hydrofiber Ag dressings in patients with exposed traumatic or surgical wounds ensure safety and is it efficient?
Methods
Research Design
Considering the research problem and the possible solution required, the researchers used a rigorous design. This owes to the reality that the researchers used a “prospective, randomized, open-label, active-controlled, phase III study” (Jurzak et al., 2007). Additionally, the authors used appropriate comparisons because the study was conducted in different geographical locations. As an evidence of this, the authors conducted the study in Great Britain, France, and Germany between May 2003 and April 2004. Data collection points for the study were appropriate because the investigator examined the wound weekly. Moreover, the researchers collected data on the wound. The data collected included wound depth, wound length, and wound width. This was done upon removal of the wound dressing. It is notable that minimizing bias, blinding, external validity and threats to internal constructs were not used in the study.
Population and Sample
The population was identified and described because Jurczak et al, (2007) identified a sample of adult participants. Further, the authors stated the inclusion and exclusion criteria in addition to the baseline measure implying the sample was described in detail. It is notable that Hickson (2008) argues that purposive sampling is efficient when a study population with particular characteristics is used. Consequently, Jurczak et al, (2007) used an appropriate sampling design because the authors studied patients with wounds. It is also notable that sampling bias was minimized through randomization. Suresh and Chandrashekara (2012) argue that an appropriate sample size is important for economic reasons. Therefore, Jurczak et al, (2007) used a sample of 65 subjects to avoid overspending and reduce chances of producing ineffective results.
Data collection and Measurement
According to Hickson (2008), it is important for researchers to conceptualize and operationalize variables before collecting data. A thorough review of the publication by Jurczak et al, (2007) would make a scholar infer that the researchers operationalized their variables. This owes to the reality that statistical tests such as Fishers exact test and the Cochran-Mantel-Haenszel test require researchers to operationalize variables. Therefore, even though the authors did not mention variable operationalization, astute scholars can deduce that Jurczak et al, (2007) operationalized their variables. The authors also used appropriate instruments to collect data. For instance, the authors used the Hopkins Pain Rating Instrument (validated) was used to measure pain while the sterile cotton-tipped applicator was used to measure cotton depth. Reliability and validity of instruments was ascertained because the authors stated used a validated instrument in addition to stating that a 30% reduction in pain severity is reliable.
Procedures
According to Suresh (2011), simple randomization is applied in most clinical studies. Jurczak et al, (2007) applied simple randomization owing to the use of envelopes to randomize study participants. Nonetheless, the authors do not mention that simple randomization was used, but only describe the method used for randomization. It is critical that the authors obtained ethical approval because it ensures the rights of support staff and study participants (Hickson, 2008). As an evidence of this, the authors stated that the appro...