Lower temperature at the wound edge detected by thermography predicts undermining development in pressure ulcers: a pilot study
Lower temperature at the wound edge detected by thermography predicts undermining development in pressure ulcers: a pilot study
复制标题
DOI：
10.1111/iwj.12454
复制
发表时间：
2016-08-01
影响因子：
3.1
通讯作者：
Sanada, Hiromi
中科院分区：
文献类型：
--
作者：
Kanazawa, Toshiki;Kitamura, Aya;Sanada, Hiromi
压疮(脓液)是一种麻烦的并发症，可能会推迟伤口愈合。早期皮肤切开和清创可以防止受损脓液的恶化，因此有必要识别失活的组织区域，以确定适当的干预时机。这项回顾性队列研究评估了热像仪检测到的伤口边缘温度低于伤口床和伤口周围皮肤的温度是否可以预测评估后1周脓液的破坏发展。分析了22名患有III、IV类或不能分期的脓肿的参与者，他们接受了跨学科PU小组的检查，并进行了至少连续两周的随访。我们发现，伤口边缘温度较低的9/11脓液不会发生破坏发育，而伤口边缘温度较低的8/11脓液会发生破坏发育。在体温较低的脓液中，1周后破坏发育的相对风险为400(95%可信区间：108-147)。其敏感度为080，特异度为075，阳性预测值为073，阴性预测值为081。聚焦于伤口边缘较低温度模式的热成像评估可能提供足够的信息来预测破坏的发展。
Undermined pressure ulcers (PUs) are troublesome complications that are likely to delay wound healing. Early skin incision and debridement can prevent the deterioration of undermined PUs, thus it is necessary to identify devitalised tissue areas to determine the appropriate timing for such interventions. This retrospective cohort study evaluated whether a lower temperature at the wound edge than the wound bed and periwound skin, detected by thermography, can predict undermining development in PUs 1 week after the assessment. Twenty-two participants with category III, IV, or unstageable PUs who were examined by interdisciplinary PU team and were followed up for at least two consecutive weeks were analysed. We found 9/11 PUs without a lower temperature at the wound edge did not develop undermining development, whereas 8/11 PUs with the lower temperature did develop undermining. The relative risk of undermining development after 1 week in PUs with the lower temperature was 400 (95% confidence intervals: 108-147). The sensitivity, specificity, positive predictive value and negative predictive value were 080, 075, 073 and 081, respectively. A thermal imaging assessment focusing on a lower temperature pattern at the wound edge may provide sufficient information to predict undermining development.