How long did serious wounds take to heal under standardized care in everyday clinical settings?

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Wound-healing outcomes under standardized protocols have typically been measured in controlled clinical trials rather than natural settings. With standardized wound-care protocols validated for clinical use, researchers had an opportunity to measure outcomes in practice. They explored healing outcomes during clinical use of standardized, validated care protocols based on patient and wound assessments.

This was a prospective multicenter study of wound-healing outcomes management in real-world clinical practice. From March 26 to October 31, 2001, healing outcomes were recorded for patients in 3 long-term care facilities, 1 long-term acute care hospital, and 12 home care agencies. Staff selected wounds to receive care based on computer-generated, validated wound-care algorithms.

After diagnosis, wound dimensions and status were assessed with a tool adapted from the Pressure Sore Status Tool for use on all wounds. Wound, ostomy, and continence nursing professionals accessed consistent care protocols through telemedicine in home care or paper forms in long-term care. In the wound clinic, a physician entered assessments into a desktop computer. The protocols generally avoided gauze dressings, based on evidence that healing proceeds faster with fewer infections in environments without gauze.

Of the 767 wounds selected for standardized-protocol care, most were stage III–IV pressure ulcers (373 wounds; mean healing time, 62 days) or full-thickness venous ulcers (124 wounds; mean healing time, 57 days). Partial-thickness wounds healed faster than full-thickness wounds of the same etiology.

The researchers concluded that these results provide benchmarks for healing outcomes in natural settings and help define and address wound-care challenges. Outcomes with primarily nongauze care protocols matched or surpassed the best previously published results for similar wounds treated with gauze-based protocols, including protocols using gauze impregnated with growth factors or other agents.