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Wound bed score and its correlation with healing of chronic wounds.
Dermatol Ther. 2006 Nov-Dec; 19(6):383-90.DT

Abstract

Adequate wound bed preparation is essential for healing of leg ulcers, and consists of controlling exudate and edema, decreasing the bacterial burden, promoting healthy granulation tissue, and removing necrotic tissue. Currently, there is no classification system for wound bed preparation that has predictive value. Based on past work and the authors' experience, we have now developed and tested a new classification system that scores the following parameters: healing edges (wound edge effect), presence of eschar, greatest wound depth/granulation tissue, amount of exudate amount, edema, peri-wound dermatitis, peri-wound callus and or fibrosis, and a pink/red wound bed. Each parameter receives a score from 0 (worst score) to 2 (best score), and all the parameter scores are added for a total score. Each wound can have a maximum score of 16 (the best score possible), to a minimum score of 0 (the worst score possible). We used this wound bed score (WBS) system in a study of 177 patients with venous ulcers who had been prospectively treated with and randomized to either conventional therapy (compression alone) or a living bilayered skin construct (BSC). We evaluated serial photographs at baseline to determine whether the results would be predictive of complete wound closure and could validate the WBS. We found that wounds that ultimately achieved full closure had a statistically significant higher WBS than those that did not heal (p = 0.0012). This was also true when separating wounds by treatment modality: standard therapy (p = 0.044) and treatment with a BSC (p = 0.011). When dividing the WBS in the following quartile groups: scores 4-10, 10-12, 12-13, and 13-16, the percentage of healed wounds correlated with the WBS (p = 0.0008). For all wounds, a one unit increase in total WBS resulted on average in a 22.8% increase in odds of healing (OR = 1.228). This WBS seems to have validity in predicting complete wound closure in wounds treated with either standard therapy or advanced modalities, such as BSC. If confirmed and widely adopted in this and other types of wounds, it could be a useful tool in both the clinical and research setting.

Authors+Show Affiliations

Department of Dermatology and Skin Surgery, Roger Williams Medical Center, Providence, RI 02908, USA. vfalanga@bu.eduNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17199681

Citation

Falanga, Vincent, et al. "Wound Bed Score and Its Correlation With Healing of Chronic Wounds." Dermatologic Therapy, vol. 19, no. 6, 2006, pp. 383-90.
Falanga V, Saap LJ, Ozonoff A. Wound bed score and its correlation with healing of chronic wounds. Dermatol Ther. 2006;19(6):383-90.
Falanga, V., Saap, L. J., & Ozonoff, A. (2006). Wound bed score and its correlation with healing of chronic wounds. Dermatologic Therapy, 19(6), 383-90.
Falanga V, Saap LJ, Ozonoff A. Wound Bed Score and Its Correlation With Healing of Chronic Wounds. Dermatol Ther. 2006 Nov-Dec;19(6):383-90. PubMed PMID: 17199681.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Wound bed score and its correlation with healing of chronic wounds. AU - Falanga,Vincent, AU - Saap,Liliana J, AU - Ozonoff,Alexander, PY - 2007/1/4/pubmed PY - 2007/3/16/medline PY - 2007/1/4/entrez SP - 383 EP - 90 JF - Dermatologic therapy JO - Dermatol Ther VL - 19 IS - 6 N2 - Adequate wound bed preparation is essential for healing of leg ulcers, and consists of controlling exudate and edema, decreasing the bacterial burden, promoting healthy granulation tissue, and removing necrotic tissue. Currently, there is no classification system for wound bed preparation that has predictive value. Based on past work and the authors' experience, we have now developed and tested a new classification system that scores the following parameters: healing edges (wound edge effect), presence of eschar, greatest wound depth/granulation tissue, amount of exudate amount, edema, peri-wound dermatitis, peri-wound callus and or fibrosis, and a pink/red wound bed. Each parameter receives a score from 0 (worst score) to 2 (best score), and all the parameter scores are added for a total score. Each wound can have a maximum score of 16 (the best score possible), to a minimum score of 0 (the worst score possible). We used this wound bed score (WBS) system in a study of 177 patients with venous ulcers who had been prospectively treated with and randomized to either conventional therapy (compression alone) or a living bilayered skin construct (BSC). We evaluated serial photographs at baseline to determine whether the results would be predictive of complete wound closure and could validate the WBS. We found that wounds that ultimately achieved full closure had a statistically significant higher WBS than those that did not heal (p = 0.0012). This was also true when separating wounds by treatment modality: standard therapy (p = 0.044) and treatment with a BSC (p = 0.011). When dividing the WBS in the following quartile groups: scores 4-10, 10-12, 12-13, and 13-16, the percentage of healed wounds correlated with the WBS (p = 0.0008). For all wounds, a one unit increase in total WBS resulted on average in a 22.8% increase in odds of healing (OR = 1.228). This WBS seems to have validity in predicting complete wound closure in wounds treated with either standard therapy or advanced modalities, such as BSC. If confirmed and widely adopted in this and other types of wounds, it could be a useful tool in both the clinical and research setting. SN - 1396-0296 UR - https://www.unboundmedicine.com/medline/citation/17199681/Wound_bed_score_and_its_correlation_with_healing_of_chronic_wounds_ L2 - https://doi.org/10.1111/j.1529-8019.2006.00096.x DB - PRIME DP - Unbound Medicine ER -