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 >or=15% PWAR at 1 week or >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.
RCT Entities:
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 >or=15% PWAR at 1 week or >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.
Authors: Jessica D Bills; Sandra J Berriman; Debby L Noble; Lawrence A Lavery; Kathryn E Davis Journal: Int Wound J Date: 2015-11-11 Impact factor: 3.315
Authors: Kathryn E Davis; Fadi C Constantine; Elaine C Macaslan; Jessica D Bills; Debby L Noble; Lawrence A Lavery Journal: J Diabetes Sci Technol Date: 2013-09-01
Authors: Erik Anesäter; K Markus Roupé; Markus Roupé; Peter Robertsson; Ola Borgquist; Christian Torbrand; Richard Ingemansson; Sandra Lindstedt; Malin Malmsjö Journal: Int Wound J Date: 2011-05-17 Impact factor: 3.315