The validity of the clinical signs and symptoms used to identify localized chronic wound infection
The validity of the clinical signs and symptoms used to identify localized chronic wound infection
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DOI：
10.1046/j.1524-475x.2001.00178.x
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发表时间：
2001-05-01
影响因子：
2.9
通讯作者：
Doebbeling, BN
中科院分区：
文献类型：
--
作者：
Gardner, SE;Frantz, RA;Doebbeling, BN
目前尚不清楚急性感染的典型体征如何准确地识别慢性伤口感染，或者继发性伤口特有的感染体征是否是这些伤口感染的更好指标。本研究的目的是检验“经典”症状（即疼痛、红斑、水肿、发热和脓毒）和继发性伤口特有症状（即浆液渗出、愈合延迟、肉芽组织变色、肉芽组织易碎、底部口袋、伤口、恶臭和伤口破裂）的有效性。对36个慢性伤口进行感染体征和症状评估，观察者间信度范围为0.53至1.00，然后对伤口进行定量培养，发现11个（31%）伤口感染，疼痛加剧，肉芽组织易碎，恶臭和伤口破裂显示基于敏感性，特异性，鉴别能力和阳性预测值的有效性。继发性创面特异性征象是较经典征象更好的慢性创面感染指标，平均敏感性分别为0.62和0.38。这些体征和症状都不是感染的必要指标，但疼痛加剧和伤口破裂都是充分的指标，特异性为100%。
It is uncertain how accurately classic signs of acute infection Identify infection in chronic wounds, or if the signs of infection specific to secondary wounds are better indicators of infection in these wounds. The purpose of this study was to examine the validity of the ''classic" signs (i.e., pain, erythema, edema, heat, and purulence) and the signs specific to secondary wounds (i.e serous exudate, delayed healing, discoloration of granulation tissue, friable granulation tissue, pocketing at the base of the,wound, lout odor, and wound breakdown). Thirty-six chronic wounds were assessed for these signs and symptoms of infection with interobserver reliability ranging from 0.53 to 1.00, The wounds were then quantitatively cultured, and 11 (31%) were found to be infected, increasing pain, friable granulation tissue, foul odor, and wound breakdown showed validity based on sensitivity, specificity, discriminatory power, and positive predictive values. The signs specific to secondary wounds were better indicators of chronic wound infection than the classic signs with a mean sensitivity of 0.62 and 0.38, respectively. None of the signs or symptoms was a necessary indicator of infection, but increasing pain and wound breakdown were both sufficient indicators with specificity of 100%.