Effectiveness of plant and animal-based interventions in preventing and reducing pressure injuries: A systematic review and meta-analysis.

BACKGROUND: Pressure injuries (PIs) are a significant concern among the elderly and bedridden patients, often resulting from prolonged pressure on the skin. Various interventions, including plant and animal-based therapies, are used to prevent and treat PIs. However, there is a lack of comprehensive understanding of the effectiveness of these natural interventions. AIM: This study aims to systematically review and conduct a meta-analysis of studies using plant and animal-based interventions to prevent and treat pressure injuries. METHODS: A systematic review and meta-analysis were performed according to the PRISMA guidelines. Searches were conducted in PubMed, Web of Science, SCOPUS, and Cochrane databases using keywords related to pressure injuries and natural interventions. Studies published between 2003 and 2023 were included. The inclusion criteria were experimental, quasi-experimental, and case-control studies. Data extraction and quality assessment were performed independently by two researchers. The effect size was calculated using Hedges' g, and heterogeneity was assessed using Cochrane Q and I2 tests. RESULTS: A total of 13,563 records were identified, with 20 studies meeting the inclusion criteria after screening and full-text review. The total sample size was 2541 participants. The meta-analysis revealed a significant overall effect size (g = -0.614, 95 % CI: -0.890 to -0.337) indicating moderate effectiveness of plant and animal-based interventions in preventing and reducing PIs. Aloe vera, olive oil, and fish oil showed significant effects with p-values <0.05. High heterogeneity was observed among the studies (Q = 91.007, p < 0.05; I2 = 79.123 %), leading to the use of a random effects model. CONCLUSIONS: Plant and animal-based interventions are moderately effective in preventing and reducing pressure injuries. These findings support the integration of natural therapies into clinical practice for PI management. Further research is needed to standardize protocols and explore the long-term effects of these interventions.