Spruijt Nicole E, Hoogbergen Maarten M, Buijs Servaas J E, Grosveld Marcel J W, Buth Jaap
Da Vinci Clinic, Geldrop, the Netherlands.
Plastic Surgeon, Catharina Hospital, Eindhoven, the Netherlands.
J Wound Care. 2019 Jul 2;28(7):446-452. doi: 10.12968/jowc.2019.28.7.446.
Wound risk-stratified analyses are clinically relevant as they can assist in identifying hard-to-heal wounds. The aim of the study is to develop risk categories for wound healing based on a limited number of reliably recordable clinical data.
This retrospective study used observational data. The primary outcome measure was wound healing at the end of treatment and the secondary outcome measure was the time to wound healing. A stratification model using regression analyses was developed to assign the patients to risk categories for wound healing and the time-to-heal.
The study cohort comprised of 540 patients. The most common wound diagnoses were diabetic ulcers, wounds in irradiated areas and wound dehiscence after surgery. Average wound duration before starting treatment at the wound centre was 11.7 months. Healing was achieved in 382 (71%) wounds, after an average treatment time of 4.4 months. A total of four risk categories for wound healing were developed by combining wound diagnosis (favourable versus unfavourable) and duration (<3 months versus >3 months). These risk categories demonstrated healing percentages ranging from 69-97% (p=0.0004) and mean time-to-healing varying from 2.7-5.9 months (p=0.01).
Using two clinical wound variables, diagnosis and duration, stratification categories were identified with significant associations with wound healing outcomes. Longer wound duration and unfavourable diagnoses, when combined into unfavourable risk categories, were associated with a lower percentage of wound healing and a longer treatment time until healing.
伤口风险分层分析具有临床相关性，因为它们有助于识别难愈合伤口。本研究的目的是基于有限数量的可可靠记录的临床数据制定伤口愈合的风险类别。
这项回顾性研究使用了观察性数据。主要结局指标是治疗结束时的伤口愈合情况，次要结局指标是伤口愈合时间。开发了一种使用回归分析的分层模型，将患者分配到伤口愈合和愈合时间的风险类别中。
研究队列包括540名患者。最常见的伤口诊断是糖尿病溃疡、放疗区域的伤口和手术后伤口裂开。在伤口中心开始治疗前，伤口的平均持续时间为11.7个月。382处（71%）伤口实现愈合，平均治疗时间为4.4个月。通过结合伤口诊断（有利与不利）和持续时间（<3个月与>3个月），总共制定了四个伤口愈合风险类别。这些风险类别显示愈合百分比在69 - 97%之间（p = 0.0004），平均愈合时间在2.7 - 5.9个月之间（p = 0.01）。
使用伤口诊断和持续时间这两个临床伤口变量，确定了与伤口愈合结果有显著关联的分层类别。当较长的伤口持续时间和不利的诊断组合成不利风险类别时，与较低的伤口愈合百分比和较长的愈合前治疗时间相关。
