Use of topical haemoglobin spray in hard-to-heal wound management: a systematic review

Objective: To synthesise the best available evidence regarding the effectiveness of using topical haemoglobin spray to promote healing in hard-to-heal wounds in adults. Method: The search strategy of this systematic review was designed to retrieve studies published across CINAHL, Medline, Cochrane Central Register of Controlled Trials, Web of Science, Embase, ERIC, Scopus and Mednar, before January 2020, and published in English. All study participants were aged ≥18 years. This review included randomised controlled trials, case–control studies and observational studies. The studies selected for retrieval were assessed by two independent reviewers for methodological validity prior to inclusion using standardised critical appraisal instruments. Results: The review included 15 studies. Overall effectiveness was demonstrated for wound closure rates, reductions in wound size, severity of wound pain and patient satisfaction with using a topical haemoglobin spray. The meta-analysis revealed a statistically significant effect of a topical haemoglobin spray in reducing the size of venous leg ulcers (VLU, effect size=0.02; 95% confidence interval: 0.00–0.09; p<0.00001) in adult patients. However, evidence of the effectiveness of using a topical haemoglobin spray in different wound types among adult patients was limited and not high-level, which precludes any strong conclusions. Conclusion: The review provides an evidence-based guide to future priorities for clinical practice. In particular, a topical haemoglobin spray was shown to have a positive impact in reducing VLU size and promoting wound healing.