Featured Articles
PT025 - DACC (dialkylcarbamoyl chloride) coated dressings
The Evidence Based Procurement Board’s (EBPB) Evidence Research Group (ERG) conducted a review of evidence for dialkylcarbamoyl chloride (DACC) coated wound dressings.
Due to the mixed results reported in the review and the few well designed studies published to date, the EBPB agreed that the evidence is currently inadequate to make a positive recommendation for the use of DACC coated wound dressings.
The board would reconsider its recommendations if better quality evidence became available. This would include studies with:
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A comparator dressing included in the study design (for example a standard, uncoated dressing).
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Longer duration and useful endpoints (for example, time taken until healing).
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Larger patient groups.
- Randomisation of patients with blinding where possible.
The ERG has issued an Evidence Review (available as a PDF download) and the EBPB have issued an Advice Statement (available as a PDF download).
If substantial new evidence becomes available, the EBPB will ask the ERG to consider the new evidence.
NOTE: The Medical Technologies Guidance by NICE on Leukomed Sorbact (MTG55, published February 2021) does not alter the conclusions drawn from the Evidence Review.
Downloads
- EBPB Advice Statement - "DACC coated dressings", Jan 2023 [PDF].
- EBPB Evidence Review - "DACC coated dressings ", Sep 2022 [PDF].
- Details
Single-Use Screws and Plates
The SMTL's R&D team has published a document on single-use screws and plates. The document is an update to a piece of work previously published in 2010 and aims to provide information on single-use screws and plates. On balance there are genuine clinical and risk-management benefits in moving to single-use pre-packaged small implants in the Welsh NHS.
The upated document can be found in the R&D section of Medidex.
- Details
DACC (dialkylcarbamoyl chloride) coated dressings - new advice from EBPB (Jan 2023)
The EBPB have issued advice and an evidence review for the use of DACC (dialkylcarbamoyl chloride) coated dressings.
Due to the mixed results reported in the review and the few well designed studies published to date, the EBPB agreed that the evidence is currently inadequate to make a positive recommendation for the use of DACC coated wound dressings.
The full statement and evidence review are available on the EBPB pages.
- Details
PT031 - Atraumatic diagnostic lumbar puncture
The EBPB were asked to look at the evidence for the use of atraumatic needles in diagnostic lumbar puncture (DLP).
The EBPB noted a clear clinical benefit to using atraumatic needles for DLP, through a reduction of post-dural puncture headache (PDPH). Economic analysis suggests that
despite the increased cost of atraumatic needles, cost savings could be achieved through PDPH reduction. The EBPB agreed that even without the potential for cost savings,
patients would still benefit from this change in needle design.
The EBPB therefore make the following recommendations:
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Welsh Health Boards and Trusts should switch to using atraumatic needles (e.g. pencil-point) instead of conventional needles (e.g. Quincke) to carry out DLP.
The EBPB Evidence Review Group (ERG) have issued an Evidence Review (available as a PDF download) and the EBPB have issued an Advice Statement (available as a PDF download).
If you become aware of a substantial change in the evidence base or circumstances related to this published advice, This email address is being protected from spambots. You need JavaScript enabled to view it. who will then consider whether a further review is necessary.
Downloads
- EBPB Advice Statement - "Atraumatic Diagnostic Lumbar Puncture", Dec 2020 [PDF].
- EBPB Evidence Review - "Atraumatic Diagnostic Lumbar Puncture", Feb 2020 [PDF].
- Details
PT028 - Farco-fill Protect - Aug 2019
The EBPB were asked to look at the evidence for the use of Farco-fill Protect, a sterile solution containing 0.3% triclosan that is used for the inflation of indwelling urinary catheters in an effort to reduce bacterial colonisation of the catheter
Following consideration of the published evidence, the EBPB consider that there is currently insufficient evidence to support its use in the Welsh NHS.
The EBPB therefore make the following recommendations:
- Welsh Health Boards and Trusts should refrain from using Farco-fill Protect until better quality evidence is available on the clinical efficacy, preferably through randomised controlled trials or sufficiently powered comparative studies with appropriate length of follow-up.
- The EBPB notes concerns from NHS personnel about the lack of data on the safety of triclosan, and whilst not addressed specifically in the Evidence Review, EBPB recommend that manufacturers address the safety concerns about the use of medical devices before they are considered for further use in the Welsh NHS.
The EBPB Evidence Review Group (ERG) have issued an Evidence Review (available as a PDF download) and the EBPB have issued an Advice Statement (available as a PDF download).
If you become aware of a substantial change in the evidence base or circumstances related to this published advice, This email address is being protected from spambots. You need JavaScript enabled to view it. who will then consider whether a further review is necessary.
Downloads
- EBPB Advice Statement - "Farco-fill protect", June 2019 [PDF].
- EBPB Evidence Review - "PT028 - Farco-fill Protect", March 2019 [PDF].
- Details
