Abstract:
:Objective: To develop a venous leg ulcer (VLU) risk stratification system for use in research and clinical practice. Approach: U.S. Wound Registry data were examined retrospectively and assigned an outcome. Bivariate analysis identified significant variables (p < 0.05) that were used to create a multivariable logistic regression model. Ulcers with data for wound area at the first visit before debridement were included in regression analysis, which was based on a 90% development sample. The model was validated on a hold-out 10% data sample. Results: The original dataset included 26,713 VLUs, of which 11,773 ulcers were eligible for preliminary analysis and 10,942 ulcers were eligible for regression analysis. The 90% development model included 9,898 ulcers, of which 7,498 healed (75.8%). The 10% validation sample included 1,044 ulcers, of which 809 healed (77.5%). The following variables significantly predicted healing: number of concurrent wounds of any etiology, wound size, wound age (in days), evidence of bioburden/infection, being nonambulatory, and hospitalization for any reason. Innovation: The VLU Wound Healing Index (WHI) is a comprehensive, validated risk stratification model for predicting VLU healing that incorporates patient- and wound-specific variables. Conclusions: The WHI can identify which VLUs most likely require adjunctive therapies to heal, prioritize referral to venous experts, risk-stratify ulcers to create more generalizable clinical trials and understand the impact of clinical interventions. The Centers for Medicare and Medicaid Services accepts this method for reporting VLU outcome under the Quality Payment Program.
journal_name
Adv Wound Care (New Rochelle)journal_title
Advances in wound careauthors
Fife CE,Horn SDdoi
10.1089/wound.2019.1038subject
Has Abstractpub_date
2020-02-01 00:00:00pages
68-77issue
2eissn
2162-1918issn
2162-1934pii
10.1089/wound.2019.1038journal_volume
9pub_type
杂志文章abstract:SIGNIFICANCE:Proteases and their inhibitors contribute to the balance between extracellular matrix (ECM) degradation and deposition, creating an equilibrium that is essential for the timely and coordinated healing of cutaneous wounds. However, when this balance is disrupted, wounds are led into a state of chronicity ch...
journal_title:Advances in wound care
pub_type: 评审
doi:10.1089/wound.2012.0370
更新日期:2013-10-01 00:00:00
abstract:PROBLEM:Lower extremity ulcers (venous, diabetic) are often unresponsive to standard treatment. Various systemic and local cellular, vascular, and anatomical factors can result in nonhealing wounds that are refractory to normal healing processes and standard care. SOLUTION:Several published wound care guidelines stron...
journal_title:Advances in wound care
pub_type: 杂志文章
doi:10.1089/wound.2011.0290
更新日期:2012-02-01 00:00:00
abstract::It was once common practice in the treatment of breast cancer for total mastectomy and axillary lymph node dissection to be conventionally performed. However, breast-conserving surgery is increasingly being performed with marked improvement in a multidisciplinary treatment approach, including surgery, chemotherapy, ir...
journal_title:Advances in wound care
pub_type: 杂志文章
doi:10.1089/wound.2012.0404
更新日期:2014-01-01 00:00:00
abstract::Significance: Advances in field-based trauma care, surgical techniques, and protective equipment have collectively facilitated the survival of a historically large number of service members (SMs) following combat trauma, although many sustained significant composite tissue injuries to the extremities, including limb l...
journal_title:Advances in wound care
pub_type: 杂志文章,评审
doi:10.1089/wound.2016.0714
更新日期:2017-08-01 00:00:00
abstract::Microtubules (MTs) are intracellular polymers that provide structure to the cell, serve as railways for intracellular transport, and regulate many cellular activities, including cell migration. The dynamicity and function of the MT cytoskeleton are determined in large part by its regulatory proteins, including the rec...
journal_title:Advances in wound care
pub_type: 杂志文章
doi:10.1089/wound.2018.0827
更新日期:2019-03-01 00:00:00
abstract::Objective: Activation of epidermal stem cells (EpSCs) from their quiescent niche is an integral component of wound reepithelialization and involves Wnt/β-catenin (β-Cat) signaling and remodeling of the actin cytoskeleton. The aim of this study was to investigate the effect of Flightless I (Flii), a cytoskeletal protei...
journal_title:Advances in wound care
pub_type: 杂志文章
doi:10.1089/wound.2018.0884
更新日期:2020-04-01 00:00:00
abstract:BACKGROUND:Adipose tissue is one of the richest sources of mesenchymal stem cells that exhibit an outstanding ability to regenerate skin. THE PROBLEM:Although the anatomical sites of adipose-derived stem cells (ASCs) in the body are relatively oxygen-deficient (i.e., 1%-5% oxygen content), ASCs are usually cultured un...
journal_title:Advances in wound care
pub_type: 评审
doi:10.1089/wound.2011.0312
更新日期:2012-08-01 00:00:00
abstract::Objective: Epidermal CD34+ stem cells located in the hair follicle (HF) bulge area are capable of inducing HF neogenesis and enhancing wound healing after transplantation. In this study, we observed CD34+ cells derived from blood directly participate in dermal regeneration during full-thickness excisional wound healin...
journal_title:Advances in wound care
pub_type: 杂志文章
doi:10.1089/wound.2019.0974
更新日期:2020-05-01 00:00:00
abstract:SIGNIFICANCE:Re-establishment of a functional vascular network is a critical component of successful wound repair. One of the most potent pro-angiogenic agents is vascular endothelial growth factor (VEGF), which, from a basic science and pre-clinical perspective, seems ideal for the therapeutic stimulation of blood ves...
journal_title:Advances in wound care
pub_type: 评审
doi:10.1089/wound.2011.0348
更新日期:2013-04-01 00:00:00
abstract::Significance: Fetal wounds heal with a regenerative phenotype that is indistinguishable from surrounding skin with restored skin integrity. Compared to this benchmark, all postnatal wound healing is impaired and characterized by scar formation. The biologic basis of the fetal regenerative phenotype can serve as a road...
journal_title:Advances in wound care
pub_type: 杂志文章,评审
doi:10.1089/wound.2014.0564
更新日期:2015-11-01 00:00:00
abstract::Objective: To investigate the caring burden and its determinants of primary informal caregiver of patients with chronic wound. Approach: A prospective cross-sectional study of 132 pairs of chronic wound care recipients and their informal caregivers was included. The characteristics of patients and their informal careg...
journal_title:Advances in wound care
pub_type: 杂志文章
doi:10.1089/wound.2018.0873
更新日期:2019-09-01 00:00:00
abstract::Significance: Chronic skin ulcers, including venous, diabetic, and pressure ulcers, constitute a major health care burden, affecting 2-6 million people in the United States alone, with projected increases in incidence owing to the aging population and rising epidemic of diabetes. The ulcers are often accompanied by pa...
journal_title:Advances in wound care
pub_type: 杂志文章,评审
doi:10.1089/wound.2018.0866
更新日期:2019-04-01 00:00:00
abstract:SIGNIFICANCE:Epidermal growth factor (EGF) and EGF receptor (EGFR) play an essential role in wound healing through stimulating epidermal and dermal regeneration. The development of new therapies for enhancing wound healing has included the use of EGF. In addition, EGFR inhibitors (EGFRis) have become a therapeutic opti...
journal_title:Advances in wound care
pub_type: 评审
doi:10.1089/wound.2011.0326
更新日期:2013-02-01 00:00:00
abstract::Chronic and hard-to-heal wounds are a tremendous burden on our healthcare system and impair the quality of life for millions of people. An emerging focus of regenerative medicine is the development of natural biomaterials that can stimulate tissue formation or repair by recreating the functional and structural propert...
journal_title:Advances in wound care
pub_type: 杂志文章
doi:10.1089/wound.2015.0652
更新日期:2015-08-01 00:00:00
abstract:SIGNIFICANCE:Scarring continues to present a significant clinical problem. Wound contraction leads to scarring and is mediated by myofibroblasts and contractile forces across the wound bed. Contracture formation can have a significant impact on the quality of life of the patient, particularly where function and appeara...
journal_title:Advances in wound care
pub_type: 评审
doi:10.1089/wound.2012.0378
更新日期:2013-05-01 00:00:00
abstract::WOUND CARE STAKEHOLDERS SHOULD REMEMBER THAT MEDICARE REIMBURSEMENT REQUIRES THREE PARTS: a relevant code, a published Medicare payment rate, and positive coverage or coverage based upon medical necessity. Qualified healthcare professionals, scientists, and manufacturers should establish a monthly routine, where they ...
journal_title:Advances in wound care
pub_type: 杂志文章
doi:10.1089/wound.2013.0498
更新日期:2013-12-01 00:00:00
abstract::Objective: Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is currently a pandemic. Although pulmonary health has been the primary focus of studies during the early days of COVID-19, development of a comprehensive understanding of this emergent disease requi...
journal_title:Advances in wound care
pub_type: 杂志文章
doi:10.1089/wound.2020.1309
更新日期:2021-02-01 00:00:00
abstract:BACKGROUND:Many wounds are difficult to heal because of the large, complex community of microbes present within the wound. THE PROBLEM:Classical laboratory culture methods do not provide an accurate picture of the microbial interactions or representation of microorganisms within a wound. There is an inherent bias in d...
journal_title:Advances in wound care
pub_type: 评审
doi:10.1089/wound.2011.0303
更新日期:2012-06-01 00:00:00
abstract::Significance: For over 30 years, there has been sustained interest in the development of mathematical models for investigating the complex mechanisms underlying each stage of the wound healing process. Despite the immense associated challenges, such models have helped usher in a paradigm shift in wound healing researc...
journal_title:Advances in wound care
pub_type: 杂志文章
doi:10.1089/wound.2019.1132
更新日期:2020-09-11 00:00:00
abstract::Objective: The use of noncultured autologous stromal vascular fraction or clinical grade adipose-derived regenerative cells (ADRCs) is a promising strategy to promote wound healing and tissue repair. Nevertheless, issues regarding the optimal mode of administration remain unclear. The purpose of this study was to comp...
journal_title:Advances in wound care
pub_type: 杂志文章
doi:10.1089/wound.2015.0672
更新日期:2016-07-01 00:00:00
abstract::Significance: Venous leg ulcers (VLUs) are susceptible to microbial invasion, and serious complications can result without the timely control of infection. Diagnosis of wound infection is primarily based on subjective clinical characteristics and patient-reported symptoms, and the treatment with antimicrobials has not...
journal_title:Advances in wound care
pub_type: 评审
doi:10.1089/wound.2014.0535
更新日期:2015-01-01 00:00:00
abstract::Significance: Skin tissue damage is a major challenge and a burden on healthcare systems, from burns and other trauma to diabetes and vascular disease. Although the biological complexities are relatively well understood, appropriate repair mechanisms are scarce. Three-dimensional bioprinting is a layer-based approach ...
journal_title:Advances in wound care
pub_type: 杂志文章,评审
doi:10.1089/wound.2017.0752
更新日期:2018-05-01 00:00:00
abstract::Objective: There are no safety or absorption studies to guide topical timolol therapy for treatment of chronic wounds. This study was undertaken to address this gap. Approach: A prospective, observational, cross-sectional comparative study of timolol plasma levels in patients after topical administration to a chronic ...
journal_title:Advances in wound care
pub_type: 杂志文章
doi:10.1089/wound.2019.0970
更新日期:2019-11-01 00:00:00
abstract::Objective: Full-thickness burn wounds require immediate coverage, and the primary clinical approaches comprise of skin allografts and autografts. The use of allografts is often temporary due to the antigenicity of allografts. In contrast, the availability of skin autografts may be limited in large burn injuries. In su...
journal_title:Advances in wound care
pub_type: 杂志文章
doi:10.1089/wound.2019.1108
更新日期:2020-05-28 00:00:00
abstract::Significance: Keloids are benign fibro-proliferative raised dermal lesions that spread beyond the original borders of the wound, continue to grow, rarely regress, and are the most common in pigmented individuals after an abnormal wound healing response. The current treatment failure and respective challenges involved ...
journal_title:Advances in wound care
pub_type: 杂志文章,评审
doi:10.1089/wound.2019.1040
更新日期:2019-12-01 00:00:00
abstract:SIGNIFICANCE:Postnatal vasculogenesis mediated via endothelial progenitor cells (EPCs) contributes to re-endothelialization and augments neovascularization after ischemia and tissue injury, providing a novel therapeutic application. However, controversy exists with respect to the origin, identification, and contributio...
journal_title:Advances in wound care
pub_type: 评审
doi:10.1089/wound.2012.0398
更新日期:2013-07-01 00:00:00
abstract::Significance: During wound healing of the skin, keratinocytes should move over while still adhering to their underlying matrix. Thus, mechanistic insights into the wound-healing process require an understanding of the forms and functions of keratinocyte matrix adhesions, specifically focal contacts and hemidesmosomes,...
journal_title:Advances in wound care
pub_type: 评审
doi:10.1089/wound.2013.0489
更新日期:2014-03-01 00:00:00
abstract::Objective: To investigate the safety, feasibility, and acceptability of a novel treatment, intermittent electrical stimulation (IES), for preventing deep tissue injury (DTI) in different healthcare settings. Approach: Testing was conducted in an acute rehabilitation unit of a general hospital, a tertiary rehabilitatio...
journal_title:Advances in wound care
pub_type: 杂志文章
doi:10.1089/wound.2014.0569
更新日期:2015-03-01 00:00:00
abstract::Significance: Biofilms in vivo are small densely packed aggregations of microbes that are highly resistant to host immune responses and treatment. They attach to each other and to nearby surfaces. Biofilms are difficult to study and identify in a clinical setting as their quantification necessitates the use of advance...
journal_title:Advances in wound care
pub_type: 杂志文章
doi:10.1089/wound.2020.1193
更新日期:2021-01-01 00:00:00
abstract::Objective: Wound healing is a complex process involving the dynamic interplay of various types of cells and bioactive factors. Impaired wound healing is characterized by a loss in synchronization of the process, resulting in non-healing chronic wounds. Human amniotic membrane (AM) has been shown to be effective in the...
journal_title:Advances in wound care
pub_type: 杂志文章
doi:10.1089/wound.2018.0931
更新日期:2019-08-01 00:00:00