| Title: |
Wound Healing Trajectories in Burn Patients and Their Impact on Mortality |
| Authors: |
Nitzschke, Stephanie L; Aden, James K; Serio-Melvin, Maria L; Shingleton, Sarah K; Chung, Kevin K; Waters, J A; King, Booker T; Burns, Christopher J; Lundy, Jonathan B; Salinas, Jose |
| Contributors: |
ARMY INST OF SURGICAL RESEARCH FORT SAM HOUSTON TX |
| Source: |
DTIC |
| Publication Year: |
2014 |
| Collection: |
Defense Technical Information Center: DTIC Technical Reports database |
| Subject Terms: |
Anatomy and Physiology; Medicine and Medical Research; BURNS(INJURIES); HEALING; MORTALITY RATE; CLINICAL MEDICINE; COMPUTER PROGRAMS; DEMOGRAPHY; INTENSIVE CARE UNITS; SIZES(DIMENSIONS); STATISTICAL ANALYSIS; WOUND HEALING TRAJECTORIES; WOUNDFLOW SOFTWARE; OWS(OPEN WOUND SIZE); RATE OF WOUND CLOSURE |
| Description: |
The rate of wound healing and its effect on mortality has not been well described. The objective of this article is to report wound healing trajectories in burn patients and analyze their effects on in-hospital mortality. The authors used software (WoundFlow) to depict burn wounds, surgical results, and healing progression at multiple time points throughout admission. Data for all patients admitted to the intensive care unit with /= 20% TBSA burned were collected retrospectively. The open wound size (OWS), which includes both unhealed burns and unhealed donor sites, was measured. We calculated the rate of wound closure (healing rate), which we defined as the change in OWS/time. We also determined the time delay (DAYS) from day of burn until day on which there was a reduction in OWS 10%. Data are medians [interquartile range]. There were 38 patients with complete data; 25 had documentation of successful healing (H), and 13 did not (NH). H differed from NH on age (38 years [32 57] vs 63 [51 74]), body mass index (27 [21 28] vs 32 [19 52]), 24-hour fluid resuscitation (12 L [10 16] vs 18 [15 20]), pressors during first 48 hours (72% vs 100%), use of renal replacement therapy (32% vs 92%), and mortality (4% vs 100%). Repeated measures analysis of covariance showed a significant difference between survivors and nonsurvivors on OWS as a function of time (P.001). Patients with a positive healing rate (+2%/day) after postburn day 20 had 100% survival whereas those with a negative healing rate ( 2%/day) had 100% mortality. For H patients, median DAYS was 41 (28 54); median DAYS/TBSA was 1.3 (1.0 1.9). Survivors had a 0.62% drop in OWS/day, or 4.3%/week. In this cohort of patients with /= 20% TBSA, there was a difference in mortality after postburn day 20, between patients with a positive healing rate (+2%/day, 100% survival) and those with a negative healing rate ( 2%/day, 100% mortality, P .05). ; Published in the Journal of Burn Care & Research, v35 n6 p474-479, Nov-Dec 2014. Presented at the 44th Annual Meeting of ... |
| Document Type: |
text |
| File Description: |
text/html |
| Language: |
English |
| Relation: |
http://www.dtic.mil/docs/citations/ADA614373 |
| Availability: |
http://www.dtic.mil/docs/citations/ADA614373; http://oai.dtic.mil/oai/oai?&verb=getRecord&metadataPrefix=html&identifier=ADA614373 |
| Rights: |
Approved for public release; distribution is unlimited. |
| Accession Number: |
edsbas.58F8978D |
| Database: |
BASE |