Why measure wound size ? - L'Infirmière Magazine n° 333 du 15/11/2013 | Espace Infirmier
 

L'infirmière Magazine n° 333 du 15/11/2013

 

FORMATION ANGLAIS

« Results of studies involving stage III or IV pressure ulcers, venous ulcers, and foot ulcers, in patients with diabetes have all shown that the percentage of a reduction in wound size after two to four weeks of care is a statistically significant, and often independent, predictor of healing. »(1)

This is because wound area, as measured over time, provides quantifiable data that can be used to help predict wound outcome. The healing trajectory of every type of chronic wound can help in the prediction of whether or not that wound is going to heal within a reasonable period of time. Protocols should be re-evaluated if a wound doesn’t exhibit a reduction in size (usually 20 % to 50 %) within two to four weeks.

Which measurement technique should be used ? The most accurate is to multiply the greatest overall wound length by the greatest length perpendicular to it.

However, the « clock method » may be used more consistently and would therefore be a better choice : the length along the 12 : 00-to-6 : 00 [head-to-toe] plane is multiplied by the length along the 9 : 00-to-3 : 00 [side-to-side] plane.

Use a disposable ruler or a grid with disposable sterile backing and cm and mm markings. The method used should always be documented, as should the patient’s position at the time of measurement.

1 – AJN, American Journal of Nursing : August 2013 – Volume 113 – Issue 8 – pp 60,61 doi : 10.1097/01.NAJ.0000432967.20419.1b – « Measuring Wounds to Improve Outcomes ». Rijswijk, Lia van MSN, RN, CWCN

Article à consulter pour la formation continue : www.hopkinsmedicine.org/gec/series/wound_care.html

MOTS ET EXPRESSIONS

Pressure ulcers (npl) Escarres

Outcome (n) Résultat final

To exhibit (v)

Ici, présenter. Aussi : exposer, étaler, exhiber

Consistently (adv) de façon systématique ; avec régularité

Disposable (adj) Jetable ; à usage unique

Baseline (n) Point de comparaison ; repère

QUESTIONS

1. Are pressure sores and ulcers the only wounds that can benefit from measurement ?

No, any chronic wound can benefit.

2. Propose a formula to calculate the percentage change between a baseline and a current wound area.

(Baseline wound area – current wound area) x 100

Baseline wound area

3. The clock method is not the most accurate. So why might it be a preferred method ?

Because it’s the method which is most likely to be accurately reproduced by different members of staff.

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