Wound‐Healing Outcomes Using Standardized Assessment and Care in Clinical Practice
Wound‐Healing Outcomes Using Standardized Assessment and Care in Clinical Practice
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在临床实践中使用标准化评估和护理的伤口愈合结果
DOI：
10.1097/00152192-200403000-00005
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发表时间：
2004
期刊：
影响因子：
--
通讯作者：
Michelle Toth
中科院分区：
文献类型：
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作者：
L. Bolton;P. McNees;L. van Rijswijk;Jean M de Leon;C. Lyder;L. Kobza;Kelly Edman;A. Scheurich;R. Shannon;Michelle Toth
采用标准化方案的伤口愈合结果通常是在对照临床试验中测量的，而不是自然环境。伤口护理的标准化方案已经过临床验证，为测量结果创造了机会。在临床使用基于患者和伤口评估的标准化经验证的护理方案期间，探索伤口愈合结果。设计：这是一项在真实世界临床实践中进行的伤口愈合结局管理的前瞻性多中心研究。方法：2001年3月26日至10月31日，记录了3家长期护理机构、1家长期急症护理医院和12家家庭护理机构的患者的愈合结果，这些机构的工作人员根据计算机生成的经验证的伤口护理算法选择接受护理的伤口。诊断后，使用改编自压疮状态工具的工具评估伤口尺寸和状态，用于所有伤口。伤口，造口，和口腔护理专业人员访问一致的护理协议，通过远程医疗在家庭护理或长期护理的纸质表格。一名医生将评估结果输入伤口诊所的台式电脑。基于在没有纱布的环境中愈合更快、感染更少的证据，方案通常避免使用纱布敷料。结果：767例选择接受简化护理方案的伤口中，大多数为III-IV期压疮（n = 373;平均愈合时间62天）或全层静脉溃疡（n = 124;平均愈合时间57天）。部分厚度伤口愈合快于相同病因的全层伤口。结论：这些结果为自然愈合结果提供了基准，有助于定义和解决伤口护理挑战。主要使用非纱布护理方案的结果与使用基于纱布的护理方案的类似伤口的先前发表的最佳结果相匹配或超过，包括应用浸渍有生长因子或其他试剂的纱布的方案。
INTRODUCTION Wound-healing outcomes applying standardized protocols have typically been measured within controlled clinical trials, not natural settings. Standardized protocols of wound care have been validated for clinical use, creating an opportunity to measure the resulting outcomes. PURPOSE Wound-healing outcomes were explored during clinical use of standardized validated protocols of care based on patient and wound assessments. DESIGN This was a prospective multicenter study of wound-healing outcomes management in real-world clinical practice. METHOD Healing outcomes from March 26 to October 31, 2001, were recorded on patients in 3 long-term care facilities, 1 long-term acute care hospital, and 12 home care agencies for wounds selected by staff to receive care based on computer-generated validated wound care algorithms. After diagnosis, wound dimensions and status were assessed using a tool adapted from the Pressure Sore Status Tool for use on all wounds. Wound, ostomy, and continence nursing professionals accessed consistent protocols of care, via telemedicine in home care or paper forms in long-term care. A physician entered assessments into a desktop computer in the wound clinic. Based on evidence that healing proceeds faster with fewer infections in environments without gauze, the protocols generally avoided gauze dressings. RESULTS Most of the 767 wounds selected to receive the standardized-protocols of care were stage III-IV pressure ulcers (n = 373; mean healing time 62 days) or full-thickness venous ulcers (n = 124; mean healing time 57 days). Partial-thickness wounds healed faster than same-etiology full-thickness wounds. CONCLUSIONS These results provide benchmarks for natural-setting healing outcomes and help to define and address wound care challenges. Outcomes primarily using nongauze protocols of care matched or surpassed best previously published results on similar wounds using gauze-based protocols of care, including protocols applying gauze impregnated with growth factors or other agents.
迈向智能伤口评估系统。
DOI：
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发表时间：
1995
期刊：
Ostomy/wound management
影响因子：
--
作者：
Bates-Jensen,BM;McNees,P
通讯作者：
McNees,P
DOI：
10.1097/00005373-198907000-00004
发表时间：
1989-07-01
影响因子：
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作者：
MADDEN, MR;NOLAN, E;STAIANOCOICO, L
通讯作者：
STAIANOCOICO, L