ABSTRACT
BACKGROUND AND PURPOSE: The purposes of this study were to compare test-retest reliability of measurements obtained by the use of a photographic method and those obtained by the use of a transparency method and to compare wound surface area (WSA) measurements obtained by these two methods. SUBJECTS: Twenty inpatients (18 male, 2 female), aged 31 +/- 16 years (mean +/- SD), participated in the study. METHODS: Tracings of ulcer borders generated by the photographic and transparency methods were digitized to obtain WSA measurements. To assess intrarater reliability for each method, 5 ulcers were measured on two occasions. The magnitude of WSA measurements obtained by the photographic and transparency methods was compared in 22 ulcers measured on one occasion and in 16 ulcers measured at 5-day intervals for 20 days. RESULTS: Intraclass correlation coefficients (ICCs) were high (ICC = .99) for each method, indicating reliability of measurements. The WSA measurements did not differ between photographic and transparency methods, either at one occasion or over a 20-day period. CONCLUSION AND DISCUSSION: We concluded that the photographic and transparency methods, as applied in this study of ulcers, provided equivalently reliable measurements and that WSA measurements obtained by the two methods were equivalent. The transparency method was more economical than the photographic method in terms of time and equipment requirements.
Subject(s)
Anthropometry/methods , Body Surface Area , Photography/standards , Pressure Ulcer/diagnosis , Adult , Analysis of Variance , Bias , Evaluation Studies as Topic , Female , Humans , Male , Observer Variation , Photography/economics , Photography/methods , Pressure Ulcer/classification , Pressure Ulcer/pathology , Reproducibility of Results , Severity of Illness IndexABSTRACT
The purpose of this study was to assess the efficacy of high voltage pulsed direct current (HVPC) for healing of pressure ulcers in patients with spinal cord injury. Seventeen patients having pressure ulcers in the pelvic region were randomly assigned to either an HVPC group or a placebo HVPC group. Treatments were given for 1 hour a day for 20 consecutive days. The HVPC protocol consisted of an aluminum-foil electrode placed over the ulcer and set at negative polarity in reference to the dispersive electrode placed on the thigh. Stimulator frequency was set at 100 pps, and an intensity of 200 V was used. Measurements of ulcer surface area were conducted before treatment and after treatment days 5, 10, 15, and 20. To measure ulcer area (in square millimeters), slides taken at each measurement time were projected at actual size, traced, and digitized. Percentage of change compared with pretreatment ulcer size was calculated for each measurement time. Ulcers in the HVPC group demonstrated significantly greater percentage-of-change decreases from their pretreatment size than did ulcers in the placebo group at days 5, 15, and 20. The results suggest that HVPC, in conjunction with good nursing care, can significantly increase the healing rate of pelvic ulcers in patients with spinal cord injury.
Subject(s)
Electric Stimulation Therapy/methods , Pressure Ulcer/therapy , Adolescent , Adult , Humans , Male , Middle Aged , Pressure Ulcer/etiology , Spinal Cord Injuries/complications , Wound HealingABSTRACT
Understanding of the healing rates of deep pressure ulcers may be enhanced in future studies by relating changes in wound volume to changes in WSA. In this report, a type of dental impression material, vinyl polysiloxane, was used to produce a model of the internal topography of a pressure ulcer. This model was used to obtain volumetric measurements of the wound cavity. A permanent replica (cast) of the wound was also fabricated. Further clinical trials investigating the reliability of this method for measuring the volume of deep pressure ulcers are indicated.
