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The wound healing trajectory and predictors with combined electric stimulation and conventional care: one outpatient wound care clinic's experience

Background Electric stimulation (E‐stim) has been found to be an effective treatment in improving wound healing rates. However, the wound healing trajectory and its related predictors for complete wound closure (CWC) have not been reported with E‐stim treatment. Materials and methods This was a retr...

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Published in:European journal of clinical investigation 2016-12, Vol.46 (12), p.1017-1023
Main Authors: Zhou, Kehua, Schenk, Ronald, Brogan, Michael S.
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Schenk, Ronald
Brogan, Michael S.
description Background Electric stimulation (E‐stim) has been found to be an effective treatment in improving wound healing rates. However, the wound healing trajectory and its related predictors for complete wound closure (CWC) have not been reported with E‐stim treatment. Materials and methods This was a retrospective study. Data on 159 patients treated at an outpatient wound clinic utilizing combined intervention of E‐stim and conventional care were included. The Kaplan–Meier healing curve together with linear regression models depicted the percentage of patients with CWC against time. Results With 100, 112 and 140 days of treatment, the percentages of patients with CWC were 59·12%, 61·01% and 65·41%, respectively. Linear regression models predicted that all patients would achieve CWC by 21·55, 22·26 and 24·80 weeks, respectively. The speed for the increase in the number and percentage of patients with CWC peaked between 50–75 days of treatment. To optimize timely healing, referral to other treatment facilities or change of treatment protocol is warranted around the peak time. With the combined intervention of E‐stim and conventional care, positive predictors for CWC included a shorter wound duration at initial evaluation (P = 0·005, OR = 3·10), better compliance with appointments (P = 0·007, OR = 3·38) and the diagnosis of venous leg ulcer (P = 0·001, OR = 3·88). Conclusions This study provided preliminary data on wound healing trajectory and predictors with combined E‐stim and conventional care. E‐stim seemed to expedite wound healing; however, further research studies are needed.
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However, the wound healing trajectory and its related predictors for complete wound closure (CWC) have not been reported with E‐stim treatment. Materials and methods This was a retrospective study. Data on 159 patients treated at an outpatient wound clinic utilizing combined intervention of E‐stim and conventional care were included. The Kaplan–Meier healing curve together with linear regression models depicted the percentage of patients with CWC against time. Results With 100, 112 and 140 days of treatment, the percentages of patients with CWC were 59·12%, 61·01% and 65·41%, respectively. Linear regression models predicted that all patients would achieve CWC by 21·55, 22·26 and 24·80 weeks, respectively. The speed for the increase in the number and percentage of patients with CWC peaked between 50–75 days of treatment. To optimize timely healing, referral to other treatment facilities or change of treatment protocol is warranted around the peak time. With the combined intervention of E‐stim and conventional care, positive predictors for CWC included a shorter wound duration at initial evaluation (P = 0·005, OR = 3·10), better compliance with appointments (P = 0·007, OR = 3·38) and the diagnosis of venous leg ulcer (P = 0·001, OR = 3·88). Conclusions This study provided preliminary data on wound healing trajectory and predictors with combined E‐stim and conventional care. E‐stim seemed to expedite wound healing; however, further research studies are needed.</description><identifier>ISSN: 0014-2972</identifier><identifier>EISSN: 1365-2362</identifier><identifier>DOI: 10.1111/eci.12685</identifier><identifier>PMID: 27709618</identifier><language>eng</language><publisher>England: Blackwell Publishing Ltd</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Ambulatory Care Facilities ; Burns - therapy ; Case-Control Studies ; Complete wound closure ; Diabetic Foot - therapy ; electric stimulation ; Electric Stimulation - methods ; Female ; Humans ; Intervention ; Kaplan-Meier Estimate ; Leg Ulcer - therapy ; Linear Models ; Male ; Middle Aged ; Patients ; predictors ; Pressure Ulcer - therapy ; Regression analysis ; Regression models ; Retrospective Studies ; Stimulation ; Surgical Wound - therapy ; Time Factors ; Trajectories ; trajectory ; Treatment Outcome ; Varicose Ulcer - therapy ; Wound Healing ; Wounds and Injuries - therapy</subject><ispartof>European journal of clinical investigation, 2016-12, Vol.46 (12), p.1017-1023</ispartof><rights>2016 Stichting European Society for Clinical Investigation Journal Foundation</rights><rights>2016 Stichting European Society for Clinical Investigation Journal Foundation.</rights><rights>Copyright © 2016 Stichting European Society for Clinical Investigation Journal Foundation. Published by John Wiley &amp; Sons Ltd</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4245-7932519b4d0ee3c26d8cfa2b0f6032a3e15210882e8ea43bb91fba21438aea103</citedby><cites>FETCH-LOGICAL-c4245-7932519b4d0ee3c26d8cfa2b0f6032a3e15210882e8ea43bb91fba21438aea103</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27709618$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zhou, Kehua</creatorcontrib><creatorcontrib>Schenk, Ronald</creatorcontrib><creatorcontrib>Brogan, Michael S.</creatorcontrib><title>The wound healing trajectory and predictors with combined electric stimulation and conventional care: one outpatient wound care clinic's experience</title><title>European journal of clinical investigation</title><addtitle>Eur J Clin Invest</addtitle><description>Background Electric stimulation (E‐stim) has been found to be an effective treatment in improving wound healing rates. However, the wound healing trajectory and its related predictors for complete wound closure (CWC) have not been reported with E‐stim treatment. Materials and methods This was a retrospective study. Data on 159 patients treated at an outpatient wound clinic utilizing combined intervention of E‐stim and conventional care were included. The Kaplan–Meier healing curve together with linear regression models depicted the percentage of patients with CWC against time. Results With 100, 112 and 140 days of treatment, the percentages of patients with CWC were 59·12%, 61·01% and 65·41%, respectively. Linear regression models predicted that all patients would achieve CWC by 21·55, 22·26 and 24·80 weeks, respectively. The speed for the increase in the number and percentage of patients with CWC peaked between 50–75 days of treatment. To optimize timely healing, referral to other treatment facilities or change of treatment protocol is warranted around the peak time. With the combined intervention of E‐stim and conventional care, positive predictors for CWC included a shorter wound duration at initial evaluation (P = 0·005, OR = 3·10), better compliance with appointments (P = 0·007, OR = 3·38) and the diagnosis of venous leg ulcer (P = 0·001, OR = 3·88). Conclusions This study provided preliminary data on wound healing trajectory and predictors with combined E‐stim and conventional care. E‐stim seemed to expedite wound healing; however, further research studies are needed.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Ambulatory Care Facilities</subject><subject>Burns - therapy</subject><subject>Case-Control Studies</subject><subject>Complete wound closure</subject><subject>Diabetic Foot - therapy</subject><subject>electric stimulation</subject><subject>Electric Stimulation - methods</subject><subject>Female</subject><subject>Humans</subject><subject>Intervention</subject><subject>Kaplan-Meier Estimate</subject><subject>Leg Ulcer - therapy</subject><subject>Linear Models</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Patients</subject><subject>predictors</subject><subject>Pressure Ulcer - therapy</subject><subject>Regression analysis</subject><subject>Regression models</subject><subject>Retrospective Studies</subject><subject>Stimulation</subject><subject>Surgical Wound - therapy</subject><subject>Time Factors</subject><subject>Trajectories</subject><subject>trajectory</subject><subject>Treatment Outcome</subject><subject>Varicose Ulcer - therapy</subject><subject>Wound Healing</subject><subject>Wounds and Injuries - therapy</subject><issn>0014-2972</issn><issn>1365-2362</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><recordid>eNqNkc1u1DAUhS0EokNhwQsgSywoi7T-iR2HHYzKULUqm0FdWo5zw3hI4tROOp3n4IXxdKZdICHhjXXv-e65lg9Cbyk5pemcgXWnlEklnqEZ5VJkjEv2HM0IoXnGyoIdoVcxrgkhinL2Eh2xoiClpGqGfi9XgDd-6mu8AtO6_iceg1mDHX3YYpPaQ4Da7cqIN25cYeu7yvVQY2gTFZzFcXTd1JrR-f5hwvr-DvpdaVpsTYBP2PeA_TQOCUrKYeFOwjbtdPZDxHA_QEiqhdfoRWPaCG8O9zH68fV8Of-WXX1fXMw_X2U2Z7nIipIzQcsqrwkAt0zWyjaGVaSRhDPDgQpGiVIMFJicV1VJm8owmnNlwFDCj9HJ3ncI_naCOOrORQtta3rwU9RUCVJIxWX-HygXXAlORELf_4Wu_RTSV0TN0mtEQilN1Mc9ZYOPMUCjh-A6E7aaEr0LVadQ9UOoiX13cJyqDuon8jHFBJztgY1rYftvJ30-v3i0zPYTLo5w_zRhwi8tC14IfXO90F8uF8vLGz7X1_wPEqq8Mw</recordid><startdate>201612</startdate><enddate>201612</enddate><creator>Zhou, Kehua</creator><creator>Schenk, Ronald</creator><creator>Brogan, Michael S.</creator><general>Blackwell Publishing Ltd</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>7U7</scope><scope>7U9</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>H94</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>201612</creationdate><title>The wound healing trajectory and predictors with combined electric stimulation and conventional care: one outpatient wound care clinic's experience</title><author>Zhou, Kehua ; Schenk, Ronald ; Brogan, Michael S.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4245-7932519b4d0ee3c26d8cfa2b0f6032a3e15210882e8ea43bb91fba21438aea103</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Ambulatory Care Facilities</topic><topic>Burns - therapy</topic><topic>Case-Control Studies</topic><topic>Complete wound closure</topic><topic>Diabetic Foot - therapy</topic><topic>electric stimulation</topic><topic>Electric Stimulation - methods</topic><topic>Female</topic><topic>Humans</topic><topic>Intervention</topic><topic>Kaplan-Meier Estimate</topic><topic>Leg Ulcer - therapy</topic><topic>Linear Models</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Patients</topic><topic>predictors</topic><topic>Pressure Ulcer - therapy</topic><topic>Regression analysis</topic><topic>Regression models</topic><topic>Retrospective Studies</topic><topic>Stimulation</topic><topic>Surgical Wound - therapy</topic><topic>Time Factors</topic><topic>Trajectories</topic><topic>trajectory</topic><topic>Treatment Outcome</topic><topic>Varicose Ulcer - therapy</topic><topic>Wound Healing</topic><topic>Wounds and Injuries - therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zhou, Kehua</creatorcontrib><creatorcontrib>Schenk, Ronald</creatorcontrib><creatorcontrib>Brogan, Michael S.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of clinical investigation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zhou, Kehua</au><au>Schenk, Ronald</au><au>Brogan, Michael S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The wound healing trajectory and predictors with combined electric stimulation and conventional care: one outpatient wound care clinic's experience</atitle><jtitle>European journal of clinical investigation</jtitle><addtitle>Eur J Clin Invest</addtitle><date>2016-12</date><risdate>2016</risdate><volume>46</volume><issue>12</issue><spage>1017</spage><epage>1023</epage><pages>1017-1023</pages><issn>0014-2972</issn><eissn>1365-2362</eissn><abstract>Background Electric stimulation (E‐stim) has been found to be an effective treatment in improving wound healing rates. However, the wound healing trajectory and its related predictors for complete wound closure (CWC) have not been reported with E‐stim treatment. Materials and methods This was a retrospective study. Data on 159 patients treated at an outpatient wound clinic utilizing combined intervention of E‐stim and conventional care were included. The Kaplan–Meier healing curve together with linear regression models depicted the percentage of patients with CWC against time. Results With 100, 112 and 140 days of treatment, the percentages of patients with CWC were 59·12%, 61·01% and 65·41%, respectively. Linear regression models predicted that all patients would achieve CWC by 21·55, 22·26 and 24·80 weeks, respectively. The speed for the increase in the number and percentage of patients with CWC peaked between 50–75 days of treatment. To optimize timely healing, referral to other treatment facilities or change of treatment protocol is warranted around the peak time. With the combined intervention of E‐stim and conventional care, positive predictors for CWC included a shorter wound duration at initial evaluation (P = 0·005, OR = 3·10), better compliance with appointments (P = 0·007, OR = 3·38) and the diagnosis of venous leg ulcer (P = 0·001, OR = 3·88). Conclusions This study provided preliminary data on wound healing trajectory and predictors with combined E‐stim and conventional care. E‐stim seemed to expedite wound healing; however, further research studies are needed.</abstract><cop>England</cop><pub>Blackwell Publishing Ltd</pub><pmid>27709618</pmid><doi>10.1111/eci.12685</doi><tpages>7</tpages></addata></record>
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subjects Adult
Aged
Aged, 80 and over
Ambulatory Care Facilities
Burns - therapy
Case-Control Studies
Complete wound closure
Diabetic Foot - therapy
electric stimulation
Electric Stimulation - methods
Female
Humans
Intervention
Kaplan-Meier Estimate
Leg Ulcer - therapy
Linear Models
Male
Middle Aged
Patients
predictors
Pressure Ulcer - therapy
Regression analysis
Regression models
Retrospective Studies
Stimulation
Surgical Wound - therapy
Time Factors
Trajectories
trajectory
Treatment Outcome
Varicose Ulcer - therapy
Wound Healing
Wounds and Injuries - therapy
title The wound healing trajectory and predictors with combined electric stimulation and conventional care: one outpatient wound care clinic's experience
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