Van Asbeck F W A, Post M W M
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.
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.
Spinal Cord. 2015 Jul;53(7):539-43. doi: 10.1038/sc.2015.40. Epub 2015 Mar 10.
This is a prospective cohort study.
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.
The study was conducted in a specialized SCI rehabilitation unit in The Netherlands.
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.
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.
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.
这是一项前瞻性队列研究。
本研究的目的是预测脊髓损伤（SCI）患者在最初4周后压疮（PU）的愈合进程。
该研究在荷兰的一个专门的SCI康复单元进行。
使用“褥疮测量棒”对SCI患者骶骨或坐骨结节处II-IV级PU的长度、宽度和深度/潜行进行每周测量。将肉芽组织-上皮形成（G-E）期前4周最大尺寸的缩小速度与第4周后直至观察结束时该尺寸的缩小速度进行比较。
对45例患者的51处PU进行了测量。在G-E期的前4周，23/51处PU的最大尺寸以每周⩾0.5厘米的速度缩小。在这23处PU中的22处，从第4周直至观察结束（第5-22周），该速度保持⩾0.5。愈合：21例患者；手术：2例患者。在28/51处PU中，该尺寸每周缩小<0.5厘米。在27/28处PU中，从第4周直至观察结束（第9-37周），该速度保持<0.5。愈合：6例患者；手术：16例患者；溃疡未愈合出院：6例患者。
使用“褥疮测量棒”对SCI患者的PU进行测量，提供了一种可靠、快速、廉价且易于掌握的床边方法，以预测SCI患者在保守治疗4周后PU的愈合进程，阳性预测值为0.95，阴性预测值为0.96。这为决定手术或替代保守治疗提供了科学依据。
