2.50
Hdl Handle:
http://hdl.handle.net/10755/152837
Type:
Presentation
Title:
Chronic Wounds: Severity, Treatment, and Outcomes
Abstract:
Chronic Wounds: Severity, Treatment, and Outcomes
Conference Sponsor:Sigma Theta Tau International
Conference Year:2007
Author:Jones, Katherine, RN, PhD
P.I. Institution Name:Case Western Reserve University
Title:Sarah Cole Hirsh Professor
[Research Presentation] Background: Chronic ulcers affect millions of people, and are a growing clinical problem seen most frequently in the elderly. Nonhealing or slow healing wounds represent a major health burden and drain on resources, contributing to substantial disability, morbidity, and cost. Basic principles of good wound care are known (manage exudate, remove necrotic tissue, treat infection), but the evidence supporting specific dressings, debridement approaches, and secondary therapies remains limited.áPurpose: The purpose of this study was to determine the extent to which wound severity, demographics, comorbid conditions, risk factors, and selected therapies influenced wound healing in older adults. Methods: This retrospective chart review study used a structured data abstraction protocol. Trained research assistants at four sites in the US reviewed the closed records of subjects treated for chronic pressure, diabetic, or venous ulcers. Data were recorded at monthly intervals over a 6 month period. Results: A total of 400 subjects were included in our database: 114 pressure, 103 diabetic, and 183 venous. Sample description was: 72.7 years old, 56.5% female, 60.6% white, 34.7% married, and 72.7% Medicare. Severity scores ranged from 0 to 15. Bivariate analysis showed that higher severity scores were associated with not healing, Medicaid insurance, enzymatic and autolytic debridement, and nutritional support. Controlling for wound severity in multivariate logistic regression models, Medicaid, more dressing type changes, higher percent antimicrobial dressings, more frequent sharp debridement, more frequent enzymatic debridement, and more instances of inappropriate debridement management, all decreased the odds of healing. Wound severity, greater use of mechanical debridement, topical antiseptics, and antimicrobial dressings, and more dressing type changes all increased the odds of not healing. Conclusions: Although wound severity plays a role in chronic wound healing, specific treatment approaches selected by clinicians also affect healing. Improving treatment decisions might improve chronic ulcer healing rates.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleChronic Wounds: Severity, Treatment, and Outcomesen_GB
dc.identifier.urihttp://hdl.handle.net/10755/152837-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Chronic Wounds: Severity, Treatment, and Outcomes</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2007</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Jones, Katherine, RN, PhD</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Case Western Reserve University</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Sarah Cole Hirsh Professor</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">katherine.jones@case.edu</td></tr><tr><td colspan="2" class="item-abstract">[Research Presentation] Background: Chronic ulcers affect millions of people, and are a growing clinical problem seen most frequently in the elderly. Nonhealing or slow healing wounds represent a major health burden and drain on resources, contributing to substantial disability, morbidity, and cost. Basic principles of good wound care are known (manage exudate, remove necrotic tissue, treat infection), but the evidence supporting specific dressings, debridement approaches, and secondary therapies remains limited.&aacute;Purpose: The purpose of this study was to determine the extent to which wound severity, demographics, comorbid conditions, risk factors, and selected therapies influenced wound healing in older adults. Methods: This retrospective chart review study used a structured data abstraction protocol. Trained research assistants at four sites in the US reviewed the closed records of subjects treated for chronic pressure, diabetic, or venous ulcers. Data were recorded at monthly intervals over a 6 month period. Results: A total of 400 subjects were included in our database: 114 pressure, 103 diabetic, and 183 venous. Sample description was: 72.7 years old, 56.5% female, 60.6% white, 34.7% married, and 72.7% Medicare. Severity scores ranged from 0 to 15. Bivariate analysis showed that higher severity scores were associated with not healing, Medicaid insurance, enzymatic and autolytic debridement, and nutritional support. Controlling for wound severity in multivariate logistic regression models, Medicaid, more dressing type changes, higher percent antimicrobial dressings, more frequent sharp debridement, more frequent enzymatic debridement, and more instances of inappropriate debridement management, all decreased the odds of healing. Wound severity, greater use of mechanical debridement, topical antiseptics, and antimicrobial dressings, and more dressing type changes all increased the odds of not healing. Conclusions: Although wound severity plays a role in chronic wound healing, specific treatment approaches selected by clinicians also affect healing. Improving treatment decisions might improve chronic ulcer healing rates.</td></tr></table>en_GB
dc.date.available2011-10-26T11:51:50Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T11:51:50Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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