Abstract: This systematic review was conducted by the New Zealand Centre for Evidence Based Nursing, a collaborating centre of The Joanna Briggs Institute for Evidence Based Nursing and Midwifery. The aim was to present the best available evidence on interventions, which are effective in preventing or reducing the prevalence of complications associated with suctioning, in hospitalised adult patients with an artificial airway who are breathing spontaneously or are artificially ventilated and who require suctioning. The specific questions addressed were as follows: Which methods of suctioning reduce the prevalence of mucosal trauma or mucosal dysfunction, and promote the removal of respiratory secretions? Which techniques or methods are effective in reducing the occurrence of suctioning -induced hypoxaemia, during or following the suctioning procedure? Which techniques or methods are effective in minimising the haemodynamic or pulmonary complications associated with the suctioning procedure?

Abstract: The objective of this meta-analysis was to assess the effectiveness of pentoxifylline as an adjunct to compression bandaging in the treatment of venous leg ulcers. The CENTRAL registers of the Cochrane Peripheral Vascular Diseases and Wounds Groups were searched – each register is routinely updated by extensive searches of electronic databases, handsearching of relevant journals and conference proceedings, and contact with product companies and experts in the field. The drug's manufacturer was contacted and the references of review articles and all obtained trials were scrutinised for further citations. Randomised controlled trials published in any language comparing pentoxifylline and compression with placebo in adult participants with venous ulceration were included. Trials must have reported a meaningful objective outcome (rates of healing, proportions healed, time to healing). Details from eligible trials (independently selected by two reviewers) were extracted and summarised by one reviewer. A second reviewer independently verified extracted data. Eleven clinical trials were identified. Five trials compared pentoxifylline with placebo (compression standard therapy). Six trials were excluded. Pentoxifylline and compression was more effective than placebo and compression (RR 1.30, 95% C1 1.10-1.54) and was robust to sensitivity analyses. The greater number of adverse effects (46 reports) occurred in the pentoxifylline group, although this was not significant (RR 1.12, 95% C1 0.77-1.62); 34 percent of adverse effects were gastro-intestinal. Seven of 21 reported withdrawals were for adverse effects. In conclusion, pentoxifylline appears an effective adjunct to compression bandaging in the treatment of venous ulcers. The absence of cost-effectiveness data suggests it not be employed as a routine adjunct, but it could be considered as for those patients not responding to compression therapy alone. The majority of adverse effects are likely to be tolerated by patients.