Were moist dressings linked to greater healing of Stage II pressure ulcers?

Details

The study sought to identify resident, wound, and treatment characteristics associated with pressure ulcer healing among long-term care residents. It was a retrospective cohort study using convenience sampling. The setting was 95 long-term care facilities across the United States participating in the National Pressure Ulcer Long-Term Care Study. The participants were 882 residents aged 18 or older who had stayed at least 14 days and had at least one Stage II to IV pressure ulcer.

For each resident, researchers collected resident and treatment characteristics and changes in pressure ulcer area over 12 weeks. Data came from medical records, the Minimum Data Set, and other records. They completed two multiple regression models, one for Stage II ulcers and one for Stage III and IV ulcers.

Stage II ulcer area decreased more with moist dressings (F=21.91, P<.001) than with dry dressings (F=13.41, P<.001). Ulcers cleaned with saline or soap showed less decrease in area (F=12.34, P<.001) than those cleaned with other cleansers, such as antiseptic, antibiotic, or commercial cleansers.

For Stage III and IV ulcers, change in area was related to sufficient enteral feeding (F=5.23, P=.02), enteral feeding without higher acuity levels (F=3.94, P=.048), ulcer size—very large (F=120.89, P=.001) and large (F=27.82, P=.001)—and dressing type: moist (F=14.70, P<.001) and dry (F=5.88, P=.02). Stage III and IV ulcers increased in area when debrided (F=5.97, P=.02).

Both overall models were significant—Stage III and IV: F=20.30, coefficient of determination (R2)=0.06, P<.001; Stage II: F=40.28, R2=0.13, P<.001—but explained little of the variation in ulcer area change. The researchers concluded that, in this sample of nursing facility residents, moist dressings were strong predictors of healing for Stage II, III, and IV ulcers, and adequate nutritional support was a strong predictor for Stage III and IV ulcers.