Percent change in wound area of diabetic foot ulcers over a 4-week period is a robust predictor of complete healing in a 12-week prospective trial
Percent change in wound area of diabetic foot ulcers over a 4-week period is a robust predictor of complete healing in a 12-week prospective trial
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DOI：
10.2337/diacare.26.6.1879
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发表时间：
2003-06-01
期刊：
影响因子：
16.2
通讯作者：
Veves, A
中科院分区：
文献类型：
--
作者：
Sheehan, P;Jones, P;Veves, A
目的-评估能力的4周愈合率预测完全愈合超过12周的时间在一个大型的前瞻性多中心试验糖尿病患者足溃疡研究设计和方法-我们检查了溃疡面积的变化超过4周的时间作为预测伤口愈合的患者谁是看到每周在12周内的前瞻性，随机对照试验。结果-在203名患者中进行了基线和4周后的伤口面积测量。发现愈合患者与12周未愈合患者4周时相对于基线的面积减少百分比之间的中点为53%。溃疡面积减少大于4周中位数的受试者的12周愈合率为58%，而溃疡面积减少小于4周中位数的受试者的愈合率仅为9%（P < 0.01）。治疗组4周时溃疡面积的绝对变化显著大于未治疗组（1.5对0.8 cm（2），p < 0.02）。愈合者4周时伤口面积的百分比变化为82%（95%CI 70-94），而未愈合者伤口面积的百分比变化为25%（15-35; P < 0.001）。结论-观察4周后足部溃疡面积的百分比变化是12周愈合的可靠预测因素。这个简单的工具可以作为糖尿病足溃疡护理的关键临床决策点，用于早期识别可能对标准护理无反应且可能需要额外治疗的患者。
OBJECTIVE - To assess the ability of the 4-week healing rate to predict complete healing over a 12-week period in a large prospective multicenter trial of diabetic patients with foot ulceration.RESEARCH DESIGN AND METHODS - We examined the change in ulcer area over a 4-week period as a predictor of wound healing within 12 weeks in patients who were seen weekly in a prospective, randomized controlled trial.RESULTS - Wound area measurements at baseline and after 4 weeks were performed in 203 patients. The midpoint between the percentage area reduction from baseline at 4 weeks in patients healed versus those not healed at 12 weeks was found to be 53%. Subjects with a reduction in ulcer area greater than the 4-week median had a 12-week healing rate of 58%, whereas those with reduction in ulcer area less than the 4-week median had a healing rate of only 9% (P < 0.01). The absolute change in ulcer area at 4 weeks was significantly greater in healers versus nonhealers (1.5 vs. 0.8 cm(2), p < 0.02). The percent change in wound area at 4 weeks in those who healed was 82% (95% CI 70-94), whereas in those who failed to heal, the percent change in wound area was 25% (15-35; P < 0.001).CONCLUSIONS - The percent change in foot ulcer area after 4 weeks of observation is a robust predictor of healing at 12 weeks. This simple tool may serve as a pivotal clinical decision point in the care of diabetic foot ulcers for early identification of patients who may not respond to standard care and may need additional treatment.