title: Prediction of healing progress of pressure ulcers by distribution analysis of protein markers on necrotic tissue: A retrospective cohort study.
abstract: Predicting the short-term healing progress of pressure ulcers is important for providing timely and appropriate intervention. Although there are some prediction methods available, these are unsuitable for ulcers with abundant necrotic tissue. We aimed to elucidate the relationship between necrotic tissue alteration and protein distributions on ulcers to establish a new prediction method. Thirty-eight pressure ulcers were retrospectively analyzed. Protein distributions on necrotic tissue were evaluated by the wound blotting at three levels: marker protein positivity, signal patterns (speckled, heterogeneous, or homogeneous), and the occupation of heterogeneous pattern. Peroxidase, alkaline phosphatase, tumor necrosis factor α, and matrix metalloproteinase-2 were used as marker proteins. One-week necrotic tissue alteration was classified as liquefaction or nonliquefaction, and associations with protein distributions were analyzed. The peroxidase positivity was significantly higher in the liquefaction than in the nonliquefaction (p = 0.031). In peroxidase-positive samples, the proportion of nonliquefaction samples was significantly higher in the heterogeneous pattern (p = 0.029). In the heterogeneous-patterned samples, the proportion of samples with an occupation values greater than the median value tended to be higher in the nonliquefaction (p = 0.087). There was no significant relationship between liquefaction and other markers. Peroxidase positivity predicts 1-week liquefaction of necrotic tissue, while a heterogeneous pattern indicates nonliquefaction.
authors.affiliation: Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.|Research Fellow of Japan Society for the Promotion of Science.
authors.forename: Aya
authors.initials: A
authors.lastname: Kitamura
authors.affiliation: Department of Life Support Technology (Molten), Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Mikako
authors.initials: M
authors.lastname: Yoshida
authors.affiliation: Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Takeo
authors.initials: T
authors.lastname: Minematsu
authors.affiliation: Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Gojiro
authors.initials: G
authors.lastname: Nakagami
authors.affiliation: Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Iizaka
authors.affiliation: Department of Dermatology, Nihon University School of Medicine, Tokyo, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Fujita
authors.affiliation: WOC Consultation room, Fujisawa City Hospital, Kanagawa, Japan.
authors.forename: Ayumi
authors.initials: A
authors.lastname: Naito
authors.affiliation: Department of Dermatology, Fujisawa City Hospital, Kanagawa, Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Takahashi
authors.affiliation: Department of Life Support Technology (Molten), Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Taketoshi
authors.initials: T
authors.lastname: Mori
authors.affiliation: Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Hiromi
authors.initials: H
authors.lastname: Sanada
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000378:metabolism; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015151:Immunoblotting; D008297:Male; D008875:Middle Aged; D009336:Necrosis / Q000378:metabolism / Q000473:pathology; D003668:Pressure Ulcer / Q000378:metabolism / Q000473:pathology*; D011379:Prognosis; D011506:Proteins / Q000378:metabolism*; D012189:Retrospective Studies; D013997:Time Factors; D014945:Wound Healing / Q000502:physiology*
chemical_list: D015415:Biomarkers; D011506:Proteins