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Oral Abstracts (Session 2 of 5)
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Moderator: John M. MacDonald, MD, FACS (Presentation 33.2) Burden of pressure ulcer care Allison Smitten, SD Candidate, Harvard School of Public Health, Boston, Mass; Laura Bolton, PhD, University of Medicine and Dentistry of New Jersey, New Brunswick, NJ, ConvaTec, Skillman, NJ; Teresa Simon, MPH, Bristol-Myers Squibb, Princeton, NJ Abstract: Pressure ulcers (PU) place heavy burdens on healthcare systems. The clinical, humanistic, and economic burdens of topical PU care were explored in real-world settings. Outcomes from March 2001–December 2002 were analyzed for 821 Stage II–IV PU on 295 patients in 1 long-term care (LTC) facility, 1 long-term acute care (LTAC) hospital, and 5 home care (HC) agencies. Staff selected wounds to receive care using standardized software-generated validated wound-care protocols* including pressure relief, guided by reliable, valid wound assessments. Wound specialists accessed protocols via telemedicine in home care, paper forms in LTC, or a desktop computer in the LTAC hospital. Protocols avoided gauze dressings, unless overruled by staff. It took a mean of 55 days to heal full-thickness (FT) PU or 27 days for partial-thickness (PT) PU (p<0.0001). Controlling for depth of 331 PU with dressings recorded, faster healing time was associated with predominant use of fiber† or hydrocolloid‡ primary dressings versus gauze (p<0.02). Infections (in 20% of PU) predicted delayed healing (p=0.0009). Pain was reported by 40% of patients. PU increase the burdens of real-world patient care. These burdens decrease for shallower PU or if protocols of care include fiber or hydrocolloid dressings. * Solutions protocols of wound care, content validated for clinical use † Most commonly used fiber dressings were AQUACEL® Hydrofiber® and Kaltostat® dressings, ConvaTec, Skillman, NJ ‡ Most commonly used hydrocolloid dressings were DuoDERM® CGF® family of dressings, ConvaTec, Skillman, NJ AQUACEL, Hydrofiber, Kaltostat, DuoDERM CGF, and Solutions are registered trademarks of ER Squibb & Sons, LLC. References 1. Beitz J, van Rijswijk L. Using wound care algorithms: a content validation study. J Wound Ostomy Continence Nurs. 1999;26(5):238–249. 2. Bolton L, McNees P, van Rijswijk L, et al. Wound-healing outcomes using standardized assessment and practice. J Wound Ostomy Continence Nurs. 2004;31(2):65–71. 3. Kerstein MD, Gemmen E, vanRijswijk L, et al. Cost and cost effectiveness of venous and pressure ulcer protocols of care. Disease Management and Health Outcomes. 2001;9(11):651–663. |
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