Gojiro Nakagami1, Hiromi Sanada2, Takuya Higashino3, Takafumi Kadono4, Gentaro Uchida5, Hideki Fujita4, Yuki Ogawa6, Yuko Yamamoto7, Shinji Iizaka6, Hiroe Koyanagi8, Sanae Sasaki8, Nobuhiko Haga9. 1. Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Japan. 2. Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Japan; Email: hsanada-tky@umin.ac.jp. 3. Department of Plastic Surgery, Asahi General Hospital, Chiba, Japan. 4. Department of Dermatology, Graduate School of Medicine, The University of Tokyo, Japan. 5. Department of Plastic Surgery, Graduate School of Medicine, The University of Tokyo, Japan. 6. Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Japan. 7. Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Japan. 8. Department of Nursing, The University of Tokyo Hospital, Japan. 9. Department of Rehabilitation Medicine, Graduate School of Medicine, The University of Tokyo, Japan.
Abstract
UNLABELLED: The ability to predict the prognosis of a pressure ulcer is re- quired to establish appropriate management in the early phase. The present study reports the usefulness of a combined assessment tech- nique using ultrasonography and thermography for predicting delayed wound healing. METHODS: This retrospective cohort study included 37 patients with Stage I or II pressure ulcers. The patients were followed up for at least 3 weeks. The ultrasonographic and thermographic as- sessments were conducted at the initial multidisciplinary team round. The presence of four ultrasonographic features (unclear layered struc- ture, hypoechoic lesion, discontinuous fascia, and heterogeneous hy- poechoic area) and one thermographic feature (increased temperature) were determined from within the wound bed. Wound healing was re- assessed after 2 weeks and the rate of area reduction was calculated to determine whether the pressure ulcer was healing properly. A mul- tivariate logistic analysis was used to assess the predictive values of the possible assessment features. RESULTS: A comprehensive review of the ultrasonographic and thermographic assessments of the pressure ulcers found that the combination of unclear layered structure and increased temperature was beneficial for predicting wound healing. When a pressure ulcer presented with an unclear layered structure and increased temperature in the wound bed, the risk of delayed wound healing or wound deterioration was 6.85 times higher compared with a pressure ulcer that did not have these manifestations. CONCLUSION: The combination of ultrasonographic and thermographic assessments facilitates precise prediction of pressure ulcer outcomes.
UNLABELLED: The ability to predict the prognosis of a pressure ulcer is re- quired to establish appropriate management in the early phase. The present study reports the usefulness of a combined assessment tech- nique using ultrasonography and thermography for predicting delayed wound healing. METHODS: This retrospective cohort study included 37 patients with Stage I or II pressure ulcers. The patients were followed up for at least 3 weeks. The ultrasonographic and thermographic as- sessments were conducted at the initial multidisciplinary team round. The presence of four ultrasonographic features (unclear layered struc- ture, hypoechoic lesion, discontinuous fascia, and heterogeneous hy- poechoic area) and one thermographic feature (increased temperature) were determined from within the wound bed. Wound healing was re- assessed after 2 weeks and the rate of area reduction was calculated to determine whether the pressure ulcer was healing properly. A mul- tivariate logistic analysis was used to assess the predictive values of the possible assessment features. RESULTS: A comprehensive review of the ultrasonographic and thermographic assessments of the pressure ulcers found that the combination of unclear layered structure and increased temperature was beneficial for predicting wound healing. When a pressure ulcer presented with an unclear layered structure and increased temperature in the wound bed, the risk of delayed wound healing or wound deterioration was 6.85 times higher compared with a pressure ulcer that did not have these manifestations. CONCLUSION: The combination of ultrasonographic and thermographic assessments facilitates precise prediction of pressure ulcer outcomes.