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1. What is the healing time of stage-II pressure ulcers? Findings from a secondary analysis

Author

Palese, A, Saiani, L, Ilenia, P, Laquintana, D, Stinco, G, Di Giulio, P, Perli, S, Andreatta, Michela, Rosa, F, Chini, P, Soraperra, F, Ventura, I, Suriani, Cinzia, Romani, Silvia, Zancarli, M, Martini, M, Partel, F, Bassetti, S, Kaisermann, Raffaella, Bortolotti, C, Gianordoli, M, Rizzoli, I, Nardelli, R, Pellizzari, E, Valduga, E, Castaman, M, Pordenon, M, Beltrame, Maria Bruna, Bertolo, C, Casasola, E, Del Pin, P, Giolo, S, Marcatti, E, Pecini, D, Rodaro, M, Zanon, C, Stefanon, L, Covre, L, Babbo, C, Martin, I, Roilo, A, Zanutel, M, Sabbadin, S, Boin, L, Caron, A, Martignago, E, Venturin, V, Greggio, A, Frigo, Paolo, Lazzaron, D, Tonietto, A, Zanin, B, Zorzi, Sofia, Zuanon, Annalisa, Salmaso, D, Frison, T, Marin, Ilenia, Buosi, A, Fiorese, E, Gasparin, D, Goat, B, Saccardo, Giacomo, Simonetto, O, Gomiero, Sara, Baccara, N, Ghirardello, Luca, Niolu, M, Silvestri, Sonia, Buffon, Ml, Casson, P, Santantonio, R, Albore, P, Mazzorana, E, Terziariol, L, Bulgarelli, Giorgia, Barani, E, Gasparini, P, Migliori, S, Sasso, Enrico, Marfisi, Rm, Tognoni, G, Sgaroni, G, Noro, Gabriele, and Mattiuzzo, M.

Subjects
Male, medicine.medical_specialty, Healing time, Dermatology, Stage ii, healing time, stage II pressure ulcer, healing time, re-epithelialization, law.invention, Randomized controlled trial, Re-Epithelialization, law, Secondary analysis, Medicine, Humans, Multicenter Studies as Topic, Randomized Controlled Trials as Topic, Advanced and Specialized Nursing, Aged, 80 and over, Pressure Ulcer, Management intervention, business.industry, Incidence (epidemiology), stage II pressure ulcer, Standard of Care, Confidence interval, Surgery, Northern italy, Nursing Homes, Italy, Female, business
Abstract

Pressure ulcers (PrUs) remain a concern for clinicians, patients, caregivers, and researchers. Although data on prevalence and incidence are available, as well as evidence-based prevention and management intervention, PrU healing time is underreported. OBJECTIVE: The objective of this study was to evaluate the healing time of Stage II PrUs. METHODS: Secondary analysis of data collected from a multicenter randomized clinical trial was undertaken. Patients (a) with a Stage II PrU, (b) older than 18 years, and (c) who had given informed consent were included. The endpoints of the study were complete re-epithelialization of the PrU measured with the Pressure Ulcer Scale for Healing Tool 3.0 and the healing time. A network of 46 healthcare centers located in northern Italy participated in the study. RESULTS: Two hundred seventy patients with an average age of 83.9 years (95% confidence interval [CI], 82.71Y85.10) were recruited. Among 270 Stage II PrUs included, 153 lesions healed (56.7%), whereas 74 (27.4%) were still present after 10 weeks of follow-up. For 43 lesions (15.9%), the follow-up evaluation was interrupted because of patient death or transfer to units not included in the study. The PrUs healed on an average of 22.9 days (95% CI, 20.47Y25.37 days), with a median of 18 days. The average healing time for PrUs of less than 3.1 cm2 was significantly shorter (19.2 days; 95% CI, 16.6Y21.8) compared with those 3.1 cm2 or greater (31.0 days; 95% CI, 26.4Y35.6 days) (P = .000). CONCLUSIONS: To achieve complete re-epithelialization in Stage II PrUs, it takes approximately 23 days. This is quite a long time if we consider that pressures of only 60 to 70mmHg for between 30 and 240minutes are needed to cause tissue damage. On average, a small ulcer heals 12 days faster compared with those with a surface of 3.1 cm2 or greater. KEYWORDS: Stage II pressure ulcer, healing time, re-epithelialization

Published
2015

2. Studio clinico randomizzato controllato in doppio cieco sull’efficacia dei trattamenti delle lesioni da decubito

Author

DI GIULIO, Paola, Saiani, L, Laquintana, D, Palese, A, Perli, S, Andreatta, M, Rosa, F, Chini, P, Soraperra, F, Ventura, I, Suriani, C, Romani, S, Zancarli, M, Martini, M, Partel, F, Bassetti, S, Kaisermann, R, Bortolotti, C, Gianordoli, M, Rizzoli, I, Nardelli, R, Pellizzari, E, Valduga, E, Castaman, M, Pordenon, M, Beltrame, M, Bertolo, C, Casasola, E, Del Pin, P, Giolo, S, Marcatti, E, Pecini, D, Rodaro, M, Zanon, C, Stefanon, L, Covre, L, Babbo, C, Martin, I, Roilo, A, Zanutel, M, Sabbadin, S, Boin, L, Caron, A, Martignago, E, Venturin, V, Greggio, A, Frigo, P, Lazzaron, D, Tonietto, A, Zanin, B, Zorzi, S, Zuanon, A, Salmaso, D, Frison, T, Marin, I, Buosi, A, Fiorese, E, Gasparin, D, Goat, B, Saccardo, G, Simonetto, O, Gomiero, S, Baccara, N, Ghirardello, L, Niolu, M, Silvestri, S, Buffon, Ml, Casson, P, Santantonio, R, Albore, P, Mazzorana, E, Terziariol, L, Bulgarelli, G, Barani, E, Gasparini, P, Migliori, S, Sasso, E, Marfisi, Rm, Tognoni, G, Sgaroni, G, Noro, G, and Mattiuzzo, M.

Published
2004

3. [A double blind randomised clinical trial to assess the efficacy of the treatments of the superficial pressure sores].

Author

Di Giulio P, Saiani L, Laquintana D, Palese A, Perli S, Andreatta M, Rosa F, Chini P, Soraperra F, Ventura I, Suriani C, Romani S, Zancarli M, Martini M, Partel F, Bassetti S, Kaisermann R, Bortolotti C, Gianordoli M, Rizzoli I, Nardelli R, Pellizzari E, Valduga E, Castaman M, Pordenon M, Beltrame M, Bertolo C, Casasola E, Del Pin P, Giolo S, Marcatti E, Pecini D, Rodaro M, Zanon C, Stefanon L, Covre L, Babbo C, Martin I, Roilo A, Zanutel M, Sabbadin S, Boin L, Caron A, Martignago E, Venturin V, Greggio A, Frigo P, Lazzaron D, Tonietto A, Zanin B, Zorzi S, Zuanon A, Salmaso D, Frison T, Marin I, Buosi A, Fiorese E, Gasparin D, Goat B, Saccardo G, Simonetto O, Gomiero S, Baccara N, Ghirardello L, Niolu M, Silvestri S, Buffon ML, Casson P, Santantonio R, Albore P, Mazzorana E, Terziariol L, Bulgarelli G, Barani E, Gasparini P, Migliori S, Sasso E, Marfisi RM, Tognoni G, Sgaroni G, Noro G, and Mattiuzzo M

Subjects
Aged, Aged, 80 and over, Double-Blind Method, Humans, Male, Phytotherapy, Plant Preparations therapeutic use, Pressure Ulcer drug therapy, Triticum
Abstract

In spite of the progresses of knowledge and care, pressure sores continue to be a clinically relevant problem. A double blind randomised controlled trial was organised to assess the efficacy of triticum vulgaris (Fitostimoline) vs placebo in the re-epithelisation of superficial pressure sores. Patients with stage NPUAP II or superficial pressure sores, with an expected survival of more than 3 months and eligible for a follow-up up to 8 weeks were included, over a period of 2 years in 46 clinical sites. The protocol was approved by local ethical committees and informed consent was obtained before randomisation. Medications were performed by nurses if the patient was hospitalised and by nurses or properly instructed caregivers at home. Weekly follow-up controls were assumed by nurses. Out of the 294 randomised patients 270 were included in the analyses. The two groups are comparable for the main characteristics except for Norton Scale mean values, less severe in the group assigned to active treatment (10.1+/-3.7 vs 8.9+/-3.2). The mean follow-up was of 3.8 and 4.2 weeks with a mean duration of 26+/-18 and 29+/-18 days for the experimental group and controls respectively. Seventy-six patients in the treatment group and controls (58.0 and 54.7) had their lesions re-epithelized. Adjusting results for age, initial Norton and Push scores there are no differences between treated and controls (OR 0.99 95% IC 0.60-1.67). This multicentre study, sponsored by a research group of nurses, failed to support the hypothesis that triticum vulgaris, the active component of the product Fitostimoline, given on top of recommended treatment, provides a specific therapeutic advantage in terms of frequency and timing of re-epithelization in superficial pressure sores.

Published
2004

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