Document Detail


Healing and healing rates of chronic wounds in the age of molecular pathogen diagnostics.
MedLine Citation:
PMID:  20616768     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To compare healing outcomes at a wound healing centre both before and after the introduction of molecular pathogen diagnostics. METHOD: An IT consultant was recruited to analyse the medical records of patients at a wound healing centre, comparing patient groups from 2007 and 2009 - before and after the introduction of comprehensive molecular pathogen diagnostic methods. RESULTS: Before the implementation of molecular diagnostics, 244/503 patients (48.5%) healed completely, while after implementation 298/479 patients (62.4%) healed. Furthermore, based on survival analysis and after controlling for potential confounding factors, time to healing was significantly shorter in 2009 than 2007 (p<0.05). Specifically, biofilm-based wound care, along with the implementation of comprehensive molecular diagnostics for venous leg ulcers, pressure ulcers and diabetic foot ulcers and all wounds combined showed, respectively, 21%, 23%, 25% and 22% reductions in the time to healing. In addition, after implementing molecular diagnostics, the use of expensive fi rst-line antibiotics also declined in 2009, while a broader range of targeted antibiotics was used. CONCLUSION: The results of modern molecular pathogen diagnostic applications allow comprehensive evaluation of the microbial bioburden in chronic wounds. This comprehensive diagnostic in turn has led to a more precise and targeted therapeutic approach to wound care. With the comprehensive nature of molecular diagnostics future advances in topical patient specific therapeutics are now possible.
Authors:
R D Wolcott; S B Cox; S E Dowd
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of wound care     Volume:  19     ISSN:  0969-0700     ISO Abbreviation:  J Wound Care     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-07-09     Completed Date:  2010-09-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9417080     Medline TA:  J Wound Care     Country:  England    
Other Details:
Languages:  eng     Pagination:  272-8, 280-1     Citation Subset:  N    
Affiliation:
Southwest regional Wound Care CEnter, Lubbock, Texas, USA. randy@randallwolcott.com
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Analysis of Variance
Child
Child, Preschool
Debridement
Diabetic Foot / complications
Female
Humans
Male
Middle Aged
Pathology, Molecular / methods*,  trends
Pressure Ulcer / complications
Proportional Hazards Models
Retrospective Studies
Skin Care / methods
Survival Analysis
Texas
Time Factors
Treatment Outcome
Varicose Ulcer / complications
Wound Healing*
Wound Infection* / diagnosis,  microbiology,  therapy

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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