Measuring wounds to improve outcomes.
Lia van Rijswijk is an instructor at Holy Family University School of Nursing and Allied Health Professions in Philadelphia, the clinical editor of Ostomy Wound Management, and the coordinator of Wound Wise: . The author has disclosed no potential conflicts of interest, financial or otherwise.The American journal of nursing (Impact Factor: 1.32). 08/2013; 113(8):60-1. DOI: 10.1097/01.NAJ.0000432967.20419.1b
ABSTRACT Wound measurement is the only evidence-based predictor of healing.
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ABSTRACT: To investigate the patient and healing characteristics related to full-thickness pressure ulcers, 119 consecutive patients admitted with ulcers in three acute care, four longterm care, and one rehabilitation agency were studied. Of the 119 patients with 153 pressure ulcers, only 48 (40%) had full-thickness ulcers. Compared to patients with partial-thickness ulcers, patients with full-thickness ulcers were more likely to have multiple ulcers, occasional incontinence of urine and feces, a compromised overall skin condition, and a less than optimal nutritional status at baseline. Full-thickness ulcers treated with a hydrocolloid dressing (DuoDERM Hydroactive) did not develop adverse reactions; clinicians perceived the dressing to be efficacious. Ulcers that healed during the study decreased 47% in area in two weeks. This distinguished ulcers that healed from those that did not heal. The findings suggest that ulcers that do not decrease in size within two weeks should be reevaluated for additional or alternate treatments.Decubitus 02/1993; 6(1):16-21.
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ABSTRACT: Venous leg ulcers, which may take months to heal, account for 40-70% of all lower extremity chronic wounds. New treatment options for venous leg ulcers have recently been proposed, and therefore deciding which patients are candidates for these novel-and often expensive-treatments is an important task. Moreover, researchers conducting clinical trials often wish to enroll patients who are unlikely to heal in order to minimize sample sizes needed and research costs. Our purpose was to assess the use of percentage change in venous leg ulcer area over the first few weeks of treatment as a prognostic indicator of healing or non-healing at 24 weeks. We conducted a cohort study based on an existing data set from a multicentre randomized clinical trial that enrolled 104 patients. Wounds were measured using digital planimetry for 4 consecutive weeks following the inception of good wound care. Utilizing the Wilcoxon rank sum (Mann-Whitney) test, we found that percentage change in area over time distinguished between those who healed and those who failed to heal after 24 weeks of good wound care (P < 0.05). The rate of healing, or area healed per week, did not differentiate between those who healed at 24 weeks and those who did not, as all patients had similar rates of healing over the first 4 weeks of treatment. Percentage change in area from baseline to week 4 provided the best combination of positive and negative predictive values (68.2%, 74.7%) and the largest area under the receiver operating characteristic curve (0.75). Thus, percentage change in area over the first 4 weeks of treatment represents a practical and predictive measure of complete wound healing by 24 weeks.British Journal of Dermatology 05/2000; 142(5):960-4. DOI:10.1046/j.1365-2133.2000.03478.x · 4.10 Impact Factor
Longitudinal study of stage III and stage IV pressure ulcer area and perimeter as healing parameters to predict wound closure. Ostomy Wound Manage 57 50-62..
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