What Is the Healing Time of Stage II Pressure Ulcers? Findings from a Secondary Analysis

• Published in: Advances in skin & wound care Vol. 28; no. 2; pp. 69 - 75
• Main Authors: Palese, Alvisa, Luisa, Saiani, Ilenia, Pota, Laquintana, Dario, Stinco, Giuseppe, Di Giulio, Paola
• Format: Journal Article
• Language: English
• Published: United States Wolters Kluwer Health | Lippincott Williams & Wilkins. All world rights reserved 01-02-2015; Lippincott Williams & Wilkins Ovid Technologies
• Subjects: Aged, 80 and over; Female; Humans; Italy; Male; Medical research; Multicenter Studies as Topic; Nursing; Nursing Homes; Pressure Ulcer - physiopathology; Pressure Ulcer - therapy; Pressure ulcers; Randomized Controlled Trials as Topic; Re-Epithelialization - physiology; Standard of Care; Wound healing
• ISSN: 1527-7941; 1538-8654
• DOI: 10.1097/01.ASW.0000459964.49436.ce

Pressure ulcers (PrUs) remain a concern for clinicians, patients, caregivers, and researchers. Although data on prevalence and incidence are available, as well as evidence-based prevention and management intervention, PrU healing time is underreported.
OBJECTIVE:The objective of this study was to evaluate the healing time of Stage II PrUs.
METHODS:Secondary analysis of data collected from a multicenter randomized clinical trial was undertaken. Patients (a) with a Stage II PrU, (b) older than 18 years, and (c) who had given informed consent were included. The endpoints of the study were complete re-epithelialization of the PrU measured with the Pressure Ulcer Scale for Healing Tool 3.0 and the healing time. A network of 46 healthcare centers located in northern Italy participated in the study.
RESULTS:Two hundred seventy patients with an average age of 83.9 years (95% confidence interval [CI], 82.71–85.10) were recruited. Among 270 Stage II PrUs included, 153 lesions healed (56.7%), whereas 74 (27.4%) were still present after 10 weeks of follow-up. For 43 lesions (15.9%), the follow-up evaluation was interrupted because of patient death or transfer to units not included in the study. The PrUs healed on an average of 22.9 days (95% CI, 20.47–25.37 days), with a median of 18 days. The average healing time for PrUs of less than 3.1 cm was significantly shorter (19.2 days; 95% CI, 16.6–21.8) compared with those 3.1 cm or greater (31.0 days; 95% CI, 26.4–35.6 days) (P = .000).
CONCLUSIONS:To achieve complete re-epithelialization in Stage II PrUs, it takes approximately 23 days. This is quite a long time if we consider that pressures of only 60 to 70 mm Hg for between 30 and 240 minutes are needed to cause tissue damage. On average, a small ulcer heals 12 days faster compared with those with a surface of 3.1 cm or greater.