Early healing rates and wound area measurements are reliable predictors of later complete wound closure
Early healing rates and wound area measurements are reliable predictors of later complete wound closure
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DOI：
10.1111/j.1524-475x.2007.00328.x
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发表时间：
2008-01-01
影响因子：
2.9
通讯作者：
Harding, Keith
中科院分区：
文献类型：
--
作者：
Cardinal, Matthew;Eisenbud, David E.;Harding, Keith
这项研究是为了确定愈合率是否是静脉性小腿溃疡和糖尿病足伤口最终完全闭合的可靠早期预测指标。我们对306例静脉性小腿溃疡和241例糖尿病足部溃疡进行了回顾性分析，这些患者参加了两个大型对照、前瞻性、随机的关键试验，以比较局部创面治疗，以确定某些早期愈合标志是否与较晚的完全创面闭合相关。95%置信度的双侧测试表明，伤口边缘推进、初始愈合率、伤口表面积缩小百分比和伤口愈合轨迹(均为P<；0.001)是12周时伤口完全愈合的有力预测指标。根据这些标准，在4周时愈合进度较差的伤口在额外治疗8周后极有可能仍未愈合。对糖尿病足部溃疡和静脉性腿部溃疡亚组的分析分别显示了具有高度显著性的一致的统计检验结果；类似地，结果仍然有效，与所使用的局部治疗无关。使用早期愈合率对最终伤口愈合或不愈合进行早期预测，可能会使患者更有效地分流到先进的愈合技术。我们相信，这些替代标记物是可靠的愈合预测指标，无论伤口病因如何，它们值得在临床试验和常规患者护理中更广泛地使用。
This study was undertaken to determine if healing rates are reliable early predictors of ultimate complete wound closure in venous leg ulcers and diabetic foot wounds. We conducted a retrospective analysis of 306 venous leg ulcers and 241 diabetic foot ulcers enrolled in two large controlled, prospective, randomized pivotal trials to compare topical wound treatments, to determine whether certain early markers of healing could be correlated with later total wound closure. Two-sided tests at 95% confidence demonstrated that wound margin advance, initial healing rate, percent wound surface area reduction, and wound healing trajectories (all p < 0.001) were powerful predictors of complete wound healing at 12 weeks. Wounds with poor healing progress by these criteria at 4 weeks were highly likely to remain unhealed after 8 additional weeks of treatment. Analysis of the diabetic foot ulcers and venous leg ulcers subgroups separately demonstrated consistent statistical test results with high significance; similarly, the results remained valid independent of the topical treatment used. The early prediction of eventual wound healing or nonhealing using early healing rates may enable more efficient triage of patients to advanced healing technologies. We believe that these surrogate markers are robust predictors of healing regardless of wound etiology and that they merit wider use in clinical trials and routine patient care.