Document Detail


Development of the DESIGN-R with an observational study: An absolute evaluation tool for monitoring pressure ulcer wound healing.
MedLine Citation:
PMID:  21539648     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
DESIGN is a seven-item (depth, exudates, size, inflammation/infection, granulation, necrosis, and pocket) monitoring scale for pressure ulcers developed in 2002 by the scientific education committee of the Japanese Society of Pressure Ulcers. DESIGN is a very useful tool for chronological monitoring of each pressure ulcer, but a key limitation of this tool is its inability to compare the wound-healing process among different pressure ulcers in different patients due to a lack of statistical item weighting. Our aim was to weight DESIGN items by statistical analysis and develop a new validated tool to overcome this limitation. Subjects comprised 3,601 patients with pressure ulcers. Patients were followed every week during the study period. To establish the weighting of each item and grade, we estimated the probabilities of wound healing at 12-month follow-up using multivariable Cox's regression analysis. Weighting (-β value) for each item in order of the highest rank was: pocket, 2.289; size, 1.573; inflammation/infection, 0.778; granulation tissue, 0.682; exudate, 0.543; and necrotic tissue, 0.529. Based on these findings, a new, validated "DESIGN-Rating tool" for monitoring the progression of pressure ulcer healing was developed, implying the development of an absolute evaluation tool and clinical indicator to assess the quality of medical care.
Authors:
Yuko Matsui; Masutaka Furue; Hiromi Sanada; Takao Tachibana; Takeo Nakayama; Junko Sugama; Katsunori Furuta; Masahiro Tachi; Keiko Tokunaga; Yoshiki Miyachi
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-3-16
Journal Detail:
Title:  Wound repair and regeneration : official publication of the Wound Healing Society [and] the European Tissue Repair Society     Volume:  19     ISSN:  1524-475X     ISO Abbreviation:  -     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-5-4     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9310939     Medline TA:  Wound Repair Regen     Country:  -    
Other Details:
Languages:  ENG     Pagination:  309-315     Citation Subset:  -    
Copyright Information:
© 2011 by the Wound Healing Society.
Affiliation:
Department of Nursing, School of Health Sciences, Kanazawa University, Ishikawa, Japan, Department of Dermatology, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan, Department of Dermatology, Shiga University of Medical Science, Otsu, Japan, Department of Public Health, Kyoto University Graduate School of Medicine, Kyoto, Japan Division of Health Sciences, Graduate School of Medical Science, Kanazawa University, Ishikawa, Japan, Department of Pharmacology, National Center for Geriatrics and Gerontology, Aichi, Japan Department of Plastic Surgery, Tohoku University Graduate School of Medicine, Miyagi, Japan School of Nursing, Miyagi University, Miyagi, Japan, Department of Dermatology, Kyoto University Graduate School of Medicine, Kyoto, Japan.
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