Prediction of Healing for Postoperative Diabetic Foot Wounds Based on Early Wound Area Progression  

Oleh:

Lavery, Lawrence A. ; Barnes, Sunni A. ; Keith, Michael S. ; Seaman, John W. ; Armstrong, David G.

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: Diabetes Care vol. 31 no. 01 (Jan. 2008), page 26.
Topik: MWT; moist wound therapy ; NPWT; negative-pressure wound therapy ; PWAR; percentage of wound area reduction ; RCT; randomized clinical trial

Ketersediaan

Perpustakaan FK Nomor Panggil: D05.K.2008.01 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Isi artikel

OBJECTIVE—To evaluate the probability of wound healing based on percentage of wound area reduction (PWAR) at 1 and 4 weeks in individuals with large, chronic, nonischemic diabetic foot wounds following partial foot amputation. METHODS—Data from a 16-week randomized clinical trial (RCT) of 162 patients were analyzed to compare outcomes associated with negative-pressure wound therapy (NPWT) delivered through the V.A.C. Therapy System (Kinetic Concepts, San Antonio, TX) (n = 77) versus standard moist wound therapy (MWT) (n = 85). The 1- and 4-week regression models included 153 and 129 of the RCT patients, respectively. RESULTS—Early changes in PWAR were predictive of final healing at 16 weeks. Specifically, wounds that reached 15% PWAR at 1 week or 60% PWAR at 4 weeks had a 68 and 77% (respectively) probability of healing vs. a 31 and 30% probability if these wound area reductions were not achieved. Patients receiving NPWT were 2.5 times more likely to achieve both a 15% PWAR at 1 week and a 60% area reduction at 1 month (odds ratios 2.51 and 2.49, respectively) compared with those receiving MWT. CONCLUSION—Results of this study suggest that clinicians can calculate the PWAR of a wound as early as 1 week into treatment to predict the likelihood of healing at 16 weeks. This might also assist in identifying a rationale to reevaluate the wound and change wound therapies.

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