Effect of a wound healing protocol on patients with stage III and IV pressure ulcers: a preliminary observational study

Journal article


Monaco, Dario, Zaghini, Francesco, Fiorini, Jacopo, Venturini, Giulia, Iovino, Paolo, Vellone, Ercole, Alvaro, Rosaria and Sili, Alessandro. (2022). Effect of a wound healing protocol on patients with stage III and IV pressure ulcers: a preliminary observational study. Journal of Wound Care. 31(4), pp. 322-328. https://doi.org/10.12968/jowc.2022.31.4.322
AuthorsMonaco, Dario, Zaghini, Francesco, Fiorini, Jacopo, Venturini, Giulia, Iovino, Paolo, Vellone, Ercole, Alvaro, Rosaria and Sili, Alessandro
Abstract

Objective:
To evaluate the influence of a wound healing protocol for stage III and IV pressure ulcers (PUs), and to determine the predictive power of specific sociodemographic and clinical characteristics on wound healing and infection.

Method:
This longitudinal study included participants with stage III and IV PUs who were recruited from 10 acute care settings of an Italian university hospital, and who were managed with a protocol inspired by the TIMECare model. Data were collected between October 2018 and March 2019. The National Pressure Ulcer Advisory Panel Staging System was used to stage the PUs. Wound healing was assessed with the Pressure Ulcer Scale for Healing (PUSH). Nutritional status was assessed with the Mini Nutritional Assessment Index. Data collection took place at admission and every seven days thereafter—a total of six times before discharge. The outcome and predictors of wound healing were assessed with Student's paired t-tests and multiple linear regressions, respectively.

Results:
Patients (n=126) were almost equally split between male and female, with a mean age of 78.17 years and who were all retired. Stage III and IV PUs were most prevalent at the sacrum (65.5% and 73.2%, respectively). PUSH wound healing scores improved significantly after six weeks in both stage III and IV PUs (p<0.001). Nutritional status was predictive of wound healing (R2=0.12).

Conclusion:
Our results showed that a good nutritional status and a protocol inspired by the TIMECare model were associated with wound healing improvements in stage III and IV PUs. We recommend this protocol in older patients with stage III and IV PUs.

Keywordsinfection; nutritional status; observational study; pressure ulcer; Pressure Ulcer Scale for Healing; protocol; TIME; ulcer; wound; wound care; wound healing
Year2022
JournalJournal of Wound Care
Journal citation31 (4), pp. 322-328
PublisherMA Healthcare Ltd
ISSN0969-0700
Digital Object Identifier (DOI)https://doi.org/10.12968/jowc.2022.31.4.322
PubMed ID35404702
Scopus EID2-s2.0-85127978425
Page range322-328
Publisher's version
License
All rights reserved
File Access Level
Controlled
Output statusPublished
Publication dates
Online11 Apr 2022
Publication process dates
Deposited09 Aug 2023
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