title: Healing and healing rates of chronic wounds in the age of molecular pathogen diagnostics.
abstract: OBJECTIVE
  To compare healing outcomes at a wound healing centre both before and after the introduction of molecular pathogen diagnostics.
  
  
  METHODS
  An IT consultant was recruited to analyse the medical records of patients at a wound healing centre, comparing patient groups from 2007 and 2009 - before and after the introduction of comprehensive molecular pathogen diagnostic methods.
  
  
  RESULTS
  Before the implementation of molecular diagnostics, 244/503 patients (48.5%) healed completely, while after implementation 298/479 patients (62.4%) healed. Furthermore, based on survival analysis and after controlling for potential confounding factors, time to healing was significantly shorter in 2009 than 2007 (p<0.05). Specifically, biofilm-based wound care, along with the implementation of comprehensive molecular diagnostics for venous leg ulcers, pressure ulcers and diabetic foot ulcers and all wounds combined showed, respectively, 21%, 23%, 25% and 22% reductions in the time to healing. In addition, after implementing molecular diagnostics, the use of expensive fi rst-line antibiotics also declined in 2009, while a broader range of targeted antibiotics was used.
  
  
  CONCLUSIONS
  The results of modern molecular pathogen diagnostic applications allow comprehensive evaluation of the microbial bioburden in chronic wounds. This comprehensive diagnostic in turn has led to a more precise and targeted therapeutic approach to wound care. With the comprehensive nature of molecular diagnostics future advances in topical patient specific therapeutics are now possible.
authors.affiliation: Southwest regional Wound Care CEnter, Lubbock, Texas, USA. randy@randallwolcott.com
authors.forename: R D
authors.initials: RD
authors.lastname: Wolcott
authors.forename: S B
authors.initials: SB
authors.lastname: Cox
authors.forename: S E
authors.initials: SE
authors.lastname: Dowd
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D002648:Child; D002675:Child, Preschool; D003646:Debridement; D017719:Diabetic Foot / Q000150:complications; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D057089:Pathology, Molecular / Q000379:methods* / Q000639:trends; D003668:Pressure Ulcer / Q000150:complications; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D017592:Skin Care / Q000379:methods; D016019:Survival Analysis; D013781:Texas; D013997:Time Factors; D016896:Treatment Outcome; D014647:Varicose Ulcer / Q000150:complications; D014945:Wound Healing; D014946:Wound Infection / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy