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

Palese, Alvisa MNS; Saiani, Luisa MNS; Pota, Ilenia BNS, RN; Laquintana, Dario MNS; Stinco, Giuseppe MD; Di Giulio, Paola MNS, RNand on behalf of the PARI-ETLD Group

doi: 10.1097/01.ASW.0000459964.49436.ce
FEATURES: ORIGINAL INVESTIGATIONS
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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 cm2 was significantly shorter (19.2 days; 95% CI, 16.6–21.8) compared with those 3.1 cm2 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 cm2 or greater.

Alvisa Palese, MNS, is an Associate Professor, Nursing Science, Udine University, Udine, Italy. Luisa Saiani, MNS, RN, is an Associate Professor, Nursing Science, Verona University, Verona, Italy. Ilenia Pota, BNS, RN, is a Nurse, Udine University School of Nursing Research Team, Udine, Italy. Dario Laquintana, MNS, RN, is Nurse Director, Policlinico Milano, Milan, Italy. Giuseppe Stinco, MD, is a Researcher, Institute of Dermatology, Department of Experimental and Clinical Medicine, University of Udine, Udine, Italy. Paola Di Giulio, MNS, RN, is an Associate Professor, Nursing Science, University of Torino, Torino, Italy.

The authors have disclosed they have no financial relationships related to this article.

The PARI-ETLD group was the sponsor of the study and was solely responsible for study design, conduction, and analysis of the results. The principal study was made possible by a grant from Research Pharmaceutical Company “DAMOR,” which provided dressings used for the treatment and also supported the organizational and data management expenses.

Gruppo PARI-ETLD: Perli S, Andreatta M, Rosa F, Chini P, Soraperra F, Ventura I, Suriani C, Romani S, Zancarli M, Martini M, Partel F, Bassetti S, Kaisermann R, Bortolotti C, Gianordoli M, Rizzoli I, Nardelli R, Pellizzari E, Valduga E, Castaman M, Pordenon M, Beltrame M, Bertolo C, Casasola E, Del Pin P, Giolo S, Marcatti E, Pecini D, Rodaro M, Zanon C, Stefanon L, Covre L, Babbo C, Martin I, Roilo A, Zanutel M, Sabbadin S, Boin L, Caron A, Martignago E, Venturin V, Greggio A, Frigo P, Lazzaron D, Tonietto A, Zanin B, Zorzi S, Zuanon A, Salmaso D, Frison T, Marin I, Buosi A, Fiorese E, Gasparin D, Goat B, Saccardo G, Simonetto O, Gomiero S, Baccara N, Ghirardello L, Niolu M, Silvestri S, Buffon ML, Casson P, Santantonio R, Albore P, Mazzorana E, Terziariol L, Bulgarelli G, Barani E, Gasparini P, Migliori S, Sasso E, Marfisi RM, Tognoni G, Sgaroni G, Noro G, and Mattiuzzo M.

Submitted June 25, 2013: accepted in revised form March 4, 2014.

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