title: Bedside prediction of the progress of pressure ulcer healing in patients with spinal cord injury using the 'Decu-stick'.
abstract: METHODS
  This is a prospective cohort study.
  
  
  OBJECTIVE
  The objective of this study was to predict the progress of healing of pressure ulcers (PUs) in spinal cord injury (SCI) patients after the first 4 weeks.
  
  
  METHODS
  The study was conducted in a specialized SCI rehabilitation unit in The Netherlands.
  
  
  METHODS
  Weekly measurements of length, width and depth/undermining of grades II-IV PUs under sacrum or ischial tuberosity in SCI patients with the 'Decu-stick' were taken. The speed of reduction of the greatest dimension in the first 4 weeks of the granulation-epithelization (G-E) phase was compared with the speed of reduction of this dimension after week 4 until the end of observation.
  
  
  RESULTS
  Fifty-one PUs in 45 patients were measured. During the first 4 weeks of the G-E phase, the greatest dimension of 23/51 PUs reduced with a speed of ⩾0.5 cm per week. In 22 of these 23 PUs, this speed remained ⩾0.5 from week 4 until the end of observation (weeks 5-22). Closure: 21 patients (pts); operation: 2 pts. Of 28/51 PUs, this dimension reduced with <0.5 cm per week. In 27/28 PUs, this speed remained <0.5 from week 4 until the end of observation (weeks 9-37). Closure: 6 pts; operation: 16 pts; discharge with open ulcer: 6 pts.
  
  
  CONCLUSIONS
  Measurement of PUs in SCI patients with the 'Decu-stick' provides a reliable, quick, cheap and easy-to-learn bedside method to predict the progress of healing in PUs in SCI patients after 4 weeks of conservative treatment with a positive predictive value of 0.95 and an negative predictive value of 0.96. This provides a scientific basis for the decision on operative or alternative conservative treatment.
authors.affiliation: 1] Department of Spinal Cord Medicine, De Hoogstraat Rehabilitation, Utrecht, The Netherlands [2] Brain Centre Rudolf Magnus and Centre of Excellence for Rehabilitation Medicine, University Medical Centre Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands.
authors.forename: F W A
authors.initials: FW
authors.lastname: Van Asbeck
authors.affiliation: 1] Brain Centre Rudolf Magnus and Centre of Excellence for Rehabilitation Medicine, University Medical Centre Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands [2] Department of Rehabilitation Medicine, Centre for Rehabilitation, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands.
authors.forename: M W M
authors.initials: MW
authors.lastname: Post
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003880:Dermatology / Q000295:instrumentation*; D004867:Equipment Design; D005260:Female; D006801:Humans; D007512:Ischium; D008297:Male; D008875:Middle Aged; D000067716:Point-of-Care Testing; D003668:Pressure Ulcer / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D011379:Prognosis; D011446:Prospective Studies; D012447:Sacrum; D013119:Spinal Cord Injuries / Q000150:complications*; D016135:Spinal Dysraphism / Q000150:complications*; D055815:Young Adult