Wound-healing outcomes using standardized assessment and care in clinical practice.
BACKGROUND
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.


OBJECTIVE
Wound-healing outcomes were explored during clinical use of standardized validated protocols of care based on patient and wound assessments.


METHODS
This was a prospective multicenter study of wound-healing outcomes management in real-world clinical practice.


METHODS
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 Toolfor 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.
Bolton
Laura
L
ConvaTec, A Bristol-Myers Squibb Company, 200 Headquarters Park Drive, Skillman, NJ 08558, USA. laura.bolton@bms.com
McNees
Patrick
P
van Rijswijk
Lia
L
de Leon
Jean
J
Lyder
Courtney
C
Kobza
Laura
L
Edman
Kelly
K
Scheurich
Anne
A
Shannon
Ron
R
Toth
Michelle
M
D002170:Canada; D002985:Clinical Protocols; D006801:Humans; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D015203:Reproducibility of Results; D012883:Skin Ulcer / Q000451:nursing*; D014481:United States; D014945:Wound Healing; D014947:Wounds and Injuries / Q000451:nursing*