Establishing a Benchmark for Pressure Ulcer Healing

Introduction: Pressure Ulcers (PU) are the most frequent of all chronic wounds and are associated with significant costs as well as patient morbidity. Despite their ubiquity, there are no well-established benchmarks for PU healing upon which clinicians can gauge the efficacy of their care. Using a proprietary Pressure Injury Registry* from our own Mobile Wound Care Group**, we herein provide Real-World-Evidence of our protocol – guided healing rates in a large and diversified PU patient population.Methods:Inclusive of all PI patients seen from January 2022 until present, we currently have collected comprehensive source data on more than 12,000 unique PI/PU patients. We queried our database for descriptive statistics based on common explanatory variables as well as healing outcomes and time to heal when such outcomes data was available. Our primary focus for this investigation was on Standard of Care (SOC) outcomes.Results:Out of a total 12,488 unique PI/PU patients, we recorded 663 Stage 1, 3,572 Stage 2,           6,380 Stage 3, and 2,381 Stage 4 lesions. The majority of patients were Female (53.13%) and the most frequent site of PU was on the sacrococcygeal region. Mean wound area and depth of all PUs was 11.77 cm2 and 0.5 cm, respectively. While many patients left our care prior to healing, of those 7,533 patients who healed we found a mean healing time of 11.21 weeks (median 8.43 weeks). At 12, 16, and 20 weeks, 48.32%, 49.50%, and 50.20%, respectively, achieved healing with SOC methods only. Stage 2, 3, and 4 PUs healed in an average of 9.91, 13.82, and 21.73 weeks, respectively.Discussion: We have provided real-world-evidence showing that approximately 50% of all PUs can heal within 20 weeks with optimal SOC treatment. While Stage 4 lesions took longer to heal, the majority of PUs (Stage 2 and 3) that healed with SOC were healed by 14 weeks. With these data as a benchmark, we suggest that future studies on this important topic consider the generalizability of using either 14 or 20 weeks as a referent SOC healing time for PUs. *Lift-Off Pressure Ulcer Registry **United Wound Healing, Puyallup, WAReferences:1. Gould LJ, Alderden J, Aslam R, Barbul A, Bogie KM, El Masry M, Graves LY, White-Chu EF, Ahmed A, Boanca K, Brash J, Brooks KR, Cockron W, Kennerly SM, Livingston AK, Page J, Stephens C, West V, Yap TL. WHS guidelines for the treatment of pressure ulcers-2023 update. Wound Repair Regen. 2024 Jan-Feb;32(1):6-33. doi: 10.1111/wrr.13130. Epub 2023 Dec 20. PMID: 37970711. 2. European Pressure Ulcer Advisory Panel, National Pressure Injury Advisory Panel and Pan Pacific Pressure Injury Alliance. Prevention and Treatment of Pressure Ulcers/Injuries: Clinical Practice Guideline The International Guideline, Emily Haesler (Ed.), EPUAP/NPIAP/PPPIA: 2019. 3. Sugathapala RDUP, Latimer S, Balasuriya A, Chaboyer W, Thalib L, Gillespie BM. Prevalence and incidence of pressure injuries among older people living in nursing homes: A systematic review and meta-analysis. Int J Nurs Stud. 2023 Dec;148:104605. doi: 10.1016/j.ijnurstu.2023.104605. Epub 2023 Sep 14. PMID: 37801939.