Development of standard care evaluation of pressure ulcers by the molecular biological approach

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The purpose of this study was investigated the change in cytokines in refractory pressure ulcers and relationship between its changing and wound healing process. We investigated cytokines in pressure ulcers and wound change patterns in order to clarify cytokine behaviour at each status. After three days and seven days changing care measurements were performed of the levels in retained exudate of the cytokines; interleukin lα and 1β (IL-lα, 1β), basic fibroblast growth factor (bFGF), platelet-derived growth factor-AB (PDGF-AB), interleukin-4 (IL-4), transforming growth factor-β1 (TGF-β1) and vascular endothelial growth factor (VEGF). Wounds were observed weekly. All subjects had consented to participate in the study. Cytokines were increased at each wound change: for undermining adhesion, it was six out of seven (elevation in VEGF at seven three days); for increased granulation, eight out of eight (bFGF at after three days); and for epithelialization also eight out of ten (bFGF at after three days). Standard care evaluation of pressure ulcers was developed from these results. The results of our standard care evaluation were as follow: positive predictive value of bFGF 70.0% and positive predictive value of VEGF 66.7%. Therefore, it was suggested that our standard care evaluation of pressure ulcers was effective.