采用压迫疗法治疗静脉性腿部溃疡的愈合率：数据的二次分析。

Healing Rates of Venous Leg Ulcers Managed With Compression Therapy: A Secondary Analysis of Data.

机构信息

Erin M. Rajhathy, RN, BScN, MClSc, NSWOC, WOCC(C), South East Local Health Integration Network, Kingston, Ontario, Canada. Heather D. Murray, RN, BScN, MClSc, NSWOC, London Health Science Center, London, Ontario, Canada. Veronica A. Roberge, RN, BScN, MClSc, NSWOC, Castlegar, British Columbia, Canada. Kevin Y. Woo, PhD, RN, NSWOC, WOCC(C), FAPWCA, Faculty of Nursing, Queens University, Kingston, Ontario, Canada.

出版信息

J Wound Ostomy Continence Nurs. 2020 Sep/Oct;47(5):477-483. doi: 10.1097/WON.0000000000000693.

DOI:10.1097/WON.0000000000000693

PMID:32970033

Abstract

PURPOSE

The purpose of this study was to explore average time to heal for patients with venous leg ulcers (VLUs) receiving standard of care that included compression and advanced wound dressings.

DESIGN

Secondary analysis of an existing electronic database.

SUBJECT AND SETTINGS

A convenience sample consisting of 1323 patients with VLUs from various community care sectors (homecare and clinics) across Canada.

METHODS

The Wound Studies database used in the analysis consisted of data from 6 studies conducted prospectively between 1999 and 2009 in which the treatment and delivery of care for all lower leg ulcers (venous, arterial, and mixed) in Canada was examined. From these studies, only patients with VLUs, with an ankle-brachial pressure index of greater than 0.8, and surface area measurements of the ulcers at baseline, 3 months, and 6 months were included. Descriptive statistics were used to determine the proportion of patients who achieved closure at 3 and 6 months and explore the weekly and monthly healing rates for those who did and did not achieve closure. Logistic regression analysis was performed to identify predictive factors for healing.

RESULTS

A total of 777 patients (mean age 69 years) met inclusion criteria. The proportion of patients who achieved closure at 3 and 6 months was 42.2% and 48.6%, respectively. Of the participants who achieved wound closure, monthly mean healing rate, measured by percentage of reduction in surface area, was 33.4% (0.56 cm, SD 1.4 [median 0.15 cm]) through month 3, and 31.0% (0.70 cm, SD 1.6 [median 0.08 cm]) through month 6. The overall monthly surface area reduction was 30%.

CONCLUSION

Study findings suggest a monthly surface area reduction of 30% provides a baseline healing rate for VLUs managed with compression therapy and advanced dressings. Findings also suggest standard of care is not sufficient for healing in over 50% of the population, as the proportion of those who achieved closure at 3 and 6 months was 42.2% and 48.6%, respectively.

摘要

目的

本研究旨在探讨接受包括压迫和高级伤口敷料在内的标准治疗的静脉腿部溃疡（VLU）患者的平均愈合时间。

设计

对现有电子数据库的二次分析。

受试者和设置

来自加拿大各个社区护理部门（家庭护理和诊所）的 1323 例 VLU 患者的便利样本。

方法

用于分析的伤口研究数据库由 1999 年至 2009 年期间进行的 6 项前瞻性研究的数据组成，其中检查了加拿大所有小腿溃疡（静脉、动脉和混合）的治疗和护理交付情况。从这些研究中，仅包括 VLU 患者、踝肱压指数大于 0.8 以及基线、3 个月和 6 个月时溃疡表面积测量值的患者。使用描述性统计数据确定 3 个月和 6 个月时达到闭合的患者比例，并探讨达到和未达到闭合的患者每周和每月的愈合率。进行逻辑回归分析以确定愈合的预测因素。

结果

共有 777 名患者（平均年龄 69 岁）符合纳入标准。3 个月和 6 个月时达到闭合的患者比例分别为 42.2%和 48.6%。在达到伤口闭合的参与者中，通过表面积减少的百分比测量的每月平均愈合率在第 3 个月为 33.4%（0.56cm，SD 1.4[中位数 0.15cm]），在第 6 个月为 31.0%（0.70cm，SD 1.6[中位数 0.08cm]）。总的每月表面积减少为 30%。