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Electrical microcurrent therapy (EMT) consists of the application of low intensity (μA) currents that are similar to endogenous electric fields generated during wound healing. To examine the effectiveness and safety of EMT for improving wound healing and pain in people with acute or chronic wounds. Randomized clinical trials (RCTs) assessing the effectiveness of EMT in wound healing published up to August 1st, 2020 were included. The main outcomes were wound surface area, healing time, and number of wounds healed. Secondary outcomes were pain perception and adverse events. A quantitative analysis was conducted using the inverse variance and Mantel-Haenszel methods. Eight RCTs were included in the qualitative summary and seven in the quantitative analysis (n = 337 participants). EMT plus standard wound care (SWC) produced a greater decrease in wound surface [mean difference (MD) = -8.3 cm2; CI 95%: −10.5 to −6.0] and healing time (MD = -7.0 days; CI 95%: −11.9 to −2.1) that SWC alone, showing moderate and low certainty in the evidence, respectively. However, no differences were observed in the number of healed wounds [risk ratio = 2.0; CI 95%: 0.5 to 9.1], with very low quality of evidence. EMT decreased perceived pain (MD = -1.4; CI 95%: −2.7 to −0.2), but no differences in adverse effects were noted between groups (risk difference = 0.05; CI 95%: −0.06 to 0.17). EMT is an effective, safe treatment for improving wound area, healing time, and pain. Further clinical trials that include detailed intervention parameters and protocols should be designed to lower the risk of bias. • First meta-analysis evaluating the effectiveness of external microcurrents devices. • Microcurrents are more effective than standard wound care alone. • Microcurrents are effective and safe in improving wound area, healing time, and pain. • Microcurrents can be equally effective as negative pressure wound therapy. [ABSTRACT FROM AUTHOR]

Abstract Question In intubated adult patients receiving mechanical ventilation, does multimodality respiratory physiotherapy prevent ventilator-associated pneumonia, shorten length of intensive care unit (ICU) stay, and reduce mortality? Design A systematic review with meta-analysis of randomised controlled trials. Participants Intubated adult patients undergoing mechanical ventilation who were admitted to an intensive care unit. Intervention More than two respiratory physiotherapy techniques such as positioning or postural drainage, manual hyperinflation, vibration, rib springing, and suctioning. Outcomes measures Incidence of ventilator-associated pneumonia (VAP), duration of ICU stay, and mortality. Results Five trials were included in the meta-analysis. Random-effects models were used to calculate pooled weighted mean difference (WMD) for length of ICU stay and pooled risk ratio (RR) for incidence of VAP, and fixed-effects model was used to calculate pooled RR for mortality. The effect on the incidence of VAP was unclear (RR 0.73 in favour of multimodality respiratory physiotherapy, 95% CI 0.38 to 1.07). The effect on length of stay was also unclear (WMD –0.33 days shorter with multimodality respiratory physiotherapy, 95% CI –2.31 to 1.66). However, multimodality respiratory physiotherapy significantly reduced mortality (RR 0.75, 95% CI 0.58 to 0.92). Conclusion Multimodality respiratory physiotherapy appeared to reduce mortality in ICU patients. It was unclear whether this occurred via a reduction in the incidence of VAP and/or length of stay because the available data provided very imprecise estimates of the effect of multimodality respiratory physiotherapy on these outcomes. These very imprecise estimates include the possibility of very worthwhile effects on VAP incidence and length of ICU stay; therefore, these outcomes should be the focus of further investigation in rigorous trials. Registration PROSPERO CRD42018094202. [Pozuelo-Carrascosa DP, Torres-Costoso A, Alvarez-Bueno C, Cavero-Redondo I, López Muñoz P, Martínez-Vizcaíno V (2018) Multimodality respiratory physiotherapy reduces mortality but may not prevent ventilator-associated pneumonia or reduce length of stay in the intensive care unit: a systematic review. Journal of Physiotherapy 64: 222–228] [ABSTRACT FROM AUTHOR]