Evaluation of the use of prognostic information for the care of individuals with venous leg ulcers or diabetic neuropathic foot ulcers.
This is a randomized factorial design clinical trial that investigates the efficacy and feasibility of providing prognostic information on wound healing. Prognostic information was provided based on baseline or 4-week wound characteristics. Healing rates were then determined at 24 weeks for venous leg ulcers and 20 weeks for diabetic neuropathic foot ulcers. Centers that had access to baseline information for venous leg ulcer prognosis had an odds ratio (OR) of healing of 1.42 (95% confidence interval [CI]: 1.03, 1.95) while centers that had access to information at 4 weeks had an OR of healing of 1.43 (95% CI: 1.05, 1.95) compared with controls. Diabetic neuropathic foot ulcer patients treated in centers that had been randomized to receive only 4-week prognostic information were more likely to heal than individuals seen in centers randomized to receive no intervention (OR 1.50, 95% CI: 1.05, 2.14). Our study found that it is feasible and efficacious to provide prognostic information on venous leg ulcers and diabetic neuropathic foot ulcers in a wound care setting using an existing administrative database. This intervention was easy to administer and likely had low associated costs. This method of dispersing prognostic information to healthcare providers should be expanded to include recently published treatment algorithms.
Kurd
Shanu K
SK
Department of Dermatology, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA.
Hoffstad
Ole J
OJ
Bilker
Warren B
WB
Margolis
David J
DJ
D000368:Aged; D000465:Algorithms; D003646:Debridement / Q000379:methods*; D017719:Diabetic Foot / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006296:Health Services / Q000592:standards*; D006801:Humans; D008297:Male; D017410:Practice Guidelines as Topic; D011379:Prognosis; D012189:Retrospective Studies; D014647:Varicose Ulcer / Q000473:pathology / Q000601:surgery*; D014945:Wound Healing