A multidisciplinary, therapy-based, team approach for efficient and effective wound healing: a retrospective study.
This paper presents a 4-year retrospective study (1994 to 1998) of therapy-based treatment outcomes for chronic wounds of all stages and most common etiologies. Treatment in this study consists of outpatient wound treatments given by trained therapists and nurses who were supervised by the podiatrist or internist. Many patients were referred to the clinic for last-resort treatment (i.e., electrical stimulation, topical hyperbaric therapy, etc.) before major lower extremity amputations: hip disarticulation, above knee amputation (AKA), below-knee amputation (BKA). This study does not consider age, sex, chronicity, or ethnicity because the authors want to demonstrate the effectiveness of this treatment approach for healing chronic wounds notwithstanding these variables. Wound healing was achieved in 100% of patients who completed their treatment program (233 patients with 242 wounds). This study shows the total average healing time for wounds is 7 weeks for Stage II wounds, 10 weeks for Stage III wounds, and 19 weeks for Stage IV wounds. The average healing time for diabetic wounds is 14 weeks (wounds of neuropathic origin heal in 12 weeks and wounds of ischemic origin heal in 16 weeks). The average healing time for venous stasis wounds is 8 weeks. The study includes patients with ischemia who are not candidates for revascularization. The authors assert that the most effective treatment for wound healing is a therapy-based, multidisciplinary team approach. This retrospective study shows that the goal of complete healing is attainable.
Valdés
A M
AM
Wound Clinic at Norwegian American Hospital, Chicago, Ill., USA.
Angderson
C
C
Giner
J J
JJ
D000553:Ambulatory Care / Q000379:methods; D002908:Chronic Disease; D017598:Efficiency, Organizational; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team / Q000458:organization & administration*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D014945:Wound Healing; D014947:Wounds and Injuries / Q000145:classification / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*