Current ulcer care practices among leprosy patients: a systematic review protocol
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20252490Keywords:
Leprosy, Meta-analysis, Chronic ulcers, Wound healing, Ulcer careAbstract
Background: Leprosy, or Hansen’s disease, is a chronic infectious condition caused by Mycobacterium leprae or Mycobacterium lepromatosis, predominantly affecting the skin, peripheral nerves, and mucous membranes. Despite being curable, it continues to result in significant morbidity due to delayed diagnosis, stigma, and complications such as chronic trophic ulcers (CTUs). While multiple treatment options exist ranging from debridement and protective footwear to growth factor therapies but their comparative effectiveness remains unclear.
Methods: This systematic review and meta-analysis aim to evaluate the effectiveness of various ulcer care practices for individuals affected by leprosy, focusing on outcomes such as healing rates and ulcer recurrence. This systematic review will follow the PRISMA-P 2015 guidelines and is registered in PROSPERO (CRD420251010372). A thorough search will be conducted in databases such as PubMed, Google Scholar, and grey literature from 2005 to 2024. Studies included will be randomized controlled trials (RCTs) and cross-sectional studies that report on ulcer care practices in people affected by leprosy. We will include interventions like wound dressings, debridement, medications, use of footwear, and traditional methods. The quality of the studies will be assessed using standard tools: the Cochrane RoB 2 tool for randomized trials and the Joanna Briggs Institute (JBI) checklist for cross-sectional studies. Data will be analysed using R software.
Conclusions: The review will synthesize evidence on the effectiveness of ulcer care interventions in leprosy, guiding clinical decision-making and informing policy to improve healing outcomes and quality of life among affected individuals.
Trial Registration: Current control trial registration number is CRD420251010372.
Metrics
References
Leprosy (Hansen disease). Available at: https://www.who.int/data/gho/data/themes/topics/leprosy-hansens-disease. Accessed on 21 April 2025.
Leprosy. Available at: https://www.who.int/news-room/fact-sheets/detail/leprosy. Accessed on 21 April 2025.
Romero-Navarrete M, Arenas R, Han XY, Vega-Memije ME, Castillo-Solana AD. Leprosy Caused by Mycobacterium lepromatosis: Literature Review and Report of a Family in Acapulco, Mexico. Am J Clin Pathol. 2022;158(6):678-86. DOI: https://doi.org/10.1093/ajcp/aqac110
Upputuri B, Srikantam A, Mamidi RS. Comorbidities associated with non-healing of plantar ulcers in leprosy patients. PLoS Negl Trop Dis. 2020;14(6):8393. DOI: https://doi.org/10.1371/journal.pntd.0008393
Natallya F, Herwanto N, Prakoeswa C, Indramaya D, Rantam F. Effective Healing of Leprosy Chronic Plantar Ulcers by Application of Human Amniotic Membrane Stem Cell Secretome Gel. Indian J Dermatol. 2019;64(3):250. DOI: https://doi.org/10.4103/ijd.IJD_6_17
Puri V, Venkateshwaran N, Khare N. Trophic ulcers-Practical management guidelines. Indian J Plast Surg. 2019;45:340-51. DOI: https://doi.org/10.4103/0970-0358.101317
Singh M, Pawar M. Efficacy of Topical Insulin Therapy for Chronic Trophic Ulcers in Patients with Leprosy: A Randomized Interventional Pilot Study. Adv Skin Wound Care. 2020;33(2):1. DOI: https://doi.org/10.1097/01.ASW.0000617856.84426.9f
Vinay K, Sawatkar G, Dogra S, Narang T. Platelet rich fibrin dressings in the treatment of non-healing trophic ulcers of leprosy. Lepr Rev. 2018;89(2):158-64. DOI: https://doi.org/10.47276/lr.89.2.158
Anandan V, Jameela WA, Saraswathy P, Sarankumar S. Platelet Rich Plasma: Efficacy in Treating Trophic Ulcers in Leprosy. J Clin Diagn Res JCDR. 2016;10(10):6-9. DOI: https://doi.org/10.7860/JCDR/2016/21899.8758
Moher D, Shamseer L, Clarke M, Ghersi D, Liberati A, Petticrew M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev. 2015;4(1):1. DOI: https://doi.org/10.1186/2046-4053-4-1
Risk of Bias 2 (RoB 2) tool | Cochrane Methods. Available at: https://methods.cochrane.org/risk-bias-2. Accessed on 21 April 2025.
Barker TH, Stone JC, Sears K, Klugar M, Leonardi-Bee J, Tufanaru C, et al. Revising the JBI quantitative critical appraisal tools to improve their applicability: an overview of methods and the development process. JBI Evid Synth. 2023;21(3):478. DOI: https://doi.org/10.11124/JBIES-22-00125
Munn Z, Stone JC, Aromataris E, Klugar M, Sears K, Leonardi-Bee J, et al. Assessing the risk of bias of quantitative analytical studies: introducing the vision for critical appraisal within JBI systematic reviews. JBI Evid Synth. 2023;21(3):467. DOI: https://doi.org/10.11124/JBIES-22-00224
Prasad M. Introduction to the GRADE tool for rating certainty in evidence and recommendations. Clin Epidemiol Glob Health. 2024;25:101484. DOI: https://doi.org/10.1016/j.cegh.2023.101484
Gaikwad SP, Gaikwad P. A Comparative Clinical trial on trophic ulcers of Leprosy: Ayurvedic management was promising! J Med Sci Clin Res. 2022;10(08):57-64. DOI: https://doi.org/10.18535/jmscr/v10i8.11
Conde-Montero E, Horcajada-Reales C, Clavo P, Delgado-Sillero I, Suárez-Fernández R. Neuropathic ulcers in leprosy treated with intralesional platelet-rich plasma. Int Wound J. 2016;13(5):726-8. DOI: https://doi.org/10.1111/iwj.12359
Gahalaut P, Pinto J, Pai GS, Kamath J, Joshua TV. A novel treatment for plantar ulcers in leprosy: local superficial flaps. Lepr Rev. 2005;76(3):220-31. DOI: https://doi.org/10.47276/lr.76.3.220
Nunes MO, Alencar NMN, Pontes MAA, Silva PGB, Rabelo LMA, Lima-Filho JV, et al. Healing of leprosy-associated chronic plantar wounds with a novel biomembrane containing latex proteins from Calotropis procera. Braz J Biol. 2024;84:281674. DOI: https://doi.org/10.1590/1519-6984.281674
Downloads
Published
How to Cite
Issue
Section
