106 ORIGINAL ARTICLE Pressure ulcer: treatment Authorship: The Brazilian Association of Physical Medicine and Rehabilitation Final Elaboration: July 25, 2012 Partcipants: Talita Justno dos Santos Rosa, Lisley Keller Liidtke Cintra, Karla Barbosa de Freitas, Priscila Ferreira Dourado Laurindo de Alcântara, Fernando Spacassassi, Chennyfer Dobbins Paes da Rosa, Marta Imamura, Linamara Rizzo Batstella DESCRIPTION OF THE EVIDENCE COLLECTION METHODOLOGY: We initated the development of this guideline with the training of the authors, using the methodology employed by the Oxford Centre for Evidence Based Medicine, for the preparaton of clinical guidelines for the Program Guidelines of the Brazilian Medical Associaton (BMA). We subsequently conducted seven meetngs drafing the guideline, of these, three were conducted together with the BMA Program coordinators. We reviewed artcles in the MedLine database, (via PubMed), the Cochrane Database of Systematc Reviews, and the Cochrane Central Register of Controlled Trials (CENTRAL), through the Virtual Health Library, with no age limit. The search strategy used was based on structured questons in the P.I.C.O. format (from the initals: Patent, Interventon, Control and Outcome). The resultng search syntax for pressure ulcer was: QUESTION 1: ((ulcer decubitus) OR (pressure ulcer)) AND ((saline hypertonic soluton) OR (sodium chloride hypertonic soluton) OR (saline soluton)) QUESTION 2: ((ulcer decubitus) OR (bedsore) OR (bed sore) OR (pressure ulcer)) AND ((collagenase) OR (therapeutc use collagenase)) QUESTION 3: ((ulcer decubitus) OR (bedsore) OR (bed sore) OR (pressure ulcer)) AND (papain) AND (therapeutc use) OR (therapy) OR (toxicity) QUESTION 4: ((ulcer decubitus) OR (bedsore) OR (bed sore) OR (pressure ulcers)) AND ((alginate) OR (agiderm) OR (kaltostat) OR (soybean) OR (calcium alginate) OR (coverages of calcium alginate)) QUESTION 5: ((ulcer decubitus) OR (pressure ulcer) OR (Bedsore) OR (Bed Sore)) AND ((Actvated Charcoal) OR (Charcoal)) QUESTION 6: ((ulcer decubitus) OR (bedsore) OR (bed sore) OR (pressure ulcer)) AND ((Topical Negatve Pressure Therapy) OR (negatve-pressure dressing) OR (Negatve Pressure Wound Therapy) OR (vacuum assisted closure)) QUESTION 7: ((ulcer decubitus) OR (bedsore) OR (bed sore) OR (pressure ulcer) OR (wounds)) AND ((extracorporal shock wave therapy) OR (extracorporeal shock wave therapy)) NOT ((epicondilits) OR (tendinopathy) OR (bone)) QUESTION 8: ((ulcer decubitus) OR (bedsore) OR (bed sore) OR (pressure ulcer)) AND ((essental faty acids) OR (therapeutc use essental faty acids)) QUESTION 9: (pressure ulcer) AND ((Dietary supplement) OR (nutritonal supplement) OR (Dietary supplementaton)) QUESTION 10: ((ulcer decubitus) OR (bedsore) OR (bed sore) OR (pressure ulcers)) AND ((hydrocolloid) OR (bandages hydrocolloid) OR (hydrocolloid dressing) OR (duoderm) OR (comfeel) OR (hydra gran) OR (replicate) OR (restore) OR (restore plus) OR (tegasorb)) QUESTION 11: ((ulcer decubitus) OR (bedsore) OR (bed sore) OR (pressure ulcers)) AND (“Debridement”) QUESTION 12: ((ulcer decubitus) OR (bedsore) OR (bed sore) OR (Necrotc ulcer) OR (pressure ulcer) OR (Wound Healing)) AND ((hyperbaric chamber) OR (hyperbaric oxygen therapy) OR (hyperbaric oxygenatons) OR (hyperbaric therapy oxygen)) For all searches we used Field: All Fields, Limits: no age limits; with the methodological flter for study types: narrow and broad. In this manner we retrieved 1,502 artcles. On the basis of abstracts, we selected 109 works related to pressure ulcers and their treatment. We classifed the strength of scientfc evidence of these studies according to the standard of the Oxford Centre for Evidence Based Medicine. The randomized controlled trials were subjected to critcal evaluaton according to the Jadad scale, 1996. Finally, we selected 25 reference studies which, by their greater strength of scientfc evidence, quality and clinical relevance, support the recommendatons of this guideline. QUALITY OF EVIDENCE AND STRENGTH OF RECOMMENDATIONS: A: Experimental or observatonal studies of highest quality; B: Experimental or observatonal studies of lower quality; DOI: 10.5935/0104-7795.20130017