Evidence and practical wound care - An all-inclusive approach

The quest for evidence-based medicine leads one in search of best available evidence but what exactly is this? Convention guides us towards the putative gold standard of the randomised controlled trial (RCT) but this approach provides limited access to the gathering of evidence that is relevant to a 'real world' environment. Taking several examples from wound care including moist wound healing, negative pressure wound therapy and dressing wounds with gauze we show that if one takes biology into consideration, the “truth” becomes more relevant to everyday life. We suggest that solely relying on the RCT in the quest for truth is misguided and that the research community should embrace a circular model of evidence rather than a hierarchical one.