Literature DB >> 15209428

Wound-healing outcomes using standardized assessment and care in clinical practice.

Laura Bolton1, Patrick McNees, Lia van Rijswijk, Jean de Leon, Courtney Lyder, Laura Kobza, Kelly Edman, Anne Scheurich, Ron Shannon, Michelle Toth.   

Abstract

INTRODUCTION: Wound-healing outcomes applying standardized protocols have typically been measured within controlled clinical trials, not natural settings. Standardized protocols of wound care have been validated for clinical use, creating an opportunity to measure the resulting outcomes.
PURPOSE: Wound-healing outcomes were explored during clinical use of standardized validated protocols of care based on patient and wound assessments.
DESIGN: This was a prospective multicenter study of wound-healing outcomes management in real-world clinical practice.
METHOD: Healing outcomes from March 26 to October 31, 2001, were recorded on patients in 3 long-term care facilities, 1 long-term acute care hospital, and 12 home care agencies for wounds selected by staff to receive care based on computer-generated validated wound care algorithms. After diagnosis, wound dimensions and status were assessed using a tool adapted from the Pressure Sore Status Toolfor use on all wounds. Wound, ostomy, and continence nursing professionals accessed consistent protocols of care, via telemedicine in home care or paper forms in long-term care. A physician entered assessments into a desktop computer in the wound clinic. Based on evidence that healing proceeds faster with fewer infections in environments without gauze, the protocols generally avoided gauze dressings.
RESULTS: Most of the 767 wounds selected to receive the standardized-protocols of care were stage III-IV pressure ulcers (n = 373; mean healing time 62 days) or full-thickness venous ulcers (n = 124; mean healing time 57 days). Partial-thickness wounds healed faster than same-etiology full-thickness wounds.
CONCLUSIONS: These results provide benchmarks for natural-setting healing outcomes and help to define and address wound care challenges. Outcomes primarily using nongauze protocols of care matched or surpassed best previously published results on similar wounds using gauze-based protocols of care, including protocols applying gauze impregnated with growth factors or other agents.

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Year:  2004        PMID: 15209428     DOI: 10.1097/00152192-200403000-00005

Source DB:  PubMed          Journal:  J Wound Ostomy Continence Nurs        ISSN: 1071-5754            Impact factor:   1.741


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