Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.
Tor Vergata University Hospital of Rome, Rome Italy.
J Wound Care. 2022 Apr 2;31(4):322-328. doi: 10.12968/jowc.2022.31.4.322.
To evaluate the influence of a wound healing protocol for stage III and IV pressure ulcers (PUs), and to determine the predictive power of specific sociodemographic and clinical characteristics on wound healing and infection.
This longitudinal study included participants with stage III and IV PUs who were recruited from 10 acute care settings of an Italian university hospital, and who were managed with a protocol inspired by the TIMECare model. Data were collected between October 2018 and March 2019. The National Pressure Ulcer Advisory Panel Staging System was used to stage the PUs. Wound healing was assessed with the Pressure Ulcer Scale for Healing (PUSH). Nutritional status was assessed with the Mini Nutritional Assessment Index. Data collection took place at admission and every seven days thereafter-a total of six times before discharge. The outcome and predictors of wound healing were assessed with Student's paired t-tests and multiple linear regressions, respectively.
Patients (n=126) were almost equally split between male and female, with a mean age of 78.17 years and who were all retired. Stage III and IV PUs were most prevalent at the sacrum (65.5% and 73.2%, respectively). PUSH wound healing scores improved significantly after six weeks in both stage III and IV PUs (p<0.001). Nutritional status was predictive of wound healing (R=0.12).
Our results showed that a good nutritional status and a protocol inspired by the TIMECare model were associated with wound healing improvements in stage III and IV PUs. We recommend this protocol in older patients with stage III and IV PUs.
评估针对 III 期和 IV 期压力性溃疡（PU）的伤口愈合方案的影响，并确定特定社会人口学和临床特征对伤口愈合和感染的预测能力。
本纵向研究纳入了来自意大利一所大学附属医院的 10 个急性护理环境中患有 III 期和 IV 期 PU 的参与者，他们接受了基于 TIMECare 模型的方案治疗。数据收集于 2018 年 10 月至 2019 年 3 月期间进行。采用国家压力性溃疡咨询小组分期系统对 PU 进行分期。使用伤口愈合压力溃疡量表（PUSH）评估伤口愈合情况。采用微型营养评估指数评估营养状况。在入院时和此后每七天采集一次数据，共在出院前采集六次。采用学生配对 t 检验和多元线性回归分别评估伤口愈合的结局和预测因素。
患者（n=126）男女比例大致相等，平均年龄为 78.17 岁，且均已退休。骶骨是 III 期和 IV 期 PU 最常见的部位（分别为 65.5%和 73.2%）。在 III 期和 IV 期 PU 中，PUSH 伤口愈合评分在六周后均显著改善（p<0.001）。营养状况是伤口愈合的预测因素（R=0.12）。
我们的结果表明，良好的营养状况和基于 TIMECare 模型的方案与 III 期和 IV 期 PU 的伤口愈合改善相关。我们建议在患有 III 期和 IV 期 PU 的老年患者中采用该方案。
