Authors (including presenting author) :
Mak MY(1), Tang C(2), Ho S(3), Po Y(1), Lam D(2), Pang I(3), Chan J(2), Wong M(1)
Affiliation :
(1)Community Healthcare Services, Hong Kong East Cluster, (2)Department of Medicine, Pamela Youde Nethersole Eastern Hospital, (3)Department of Medicine and Geriatrics, Ruttonjee & Tang Shiu Kin Hospitals
Introduction :
The global population is aging. This demographic is at a higher risk for pressure injuries (PI) due to factors of reduced mobility and skin fragility. In HKEC Community Healthcare Services, the yearly wound care deliverable is around 48,000 within which >50% is PI. Evidence proved that effective wound progress monitoring helps improving clinical outcomes. Paper ruler is a common method for wound measurement but it is ineffective in progress monitoring. In an era of advanced technology utilization, 3D wound measurement has emerged as an alternative for its benefits of track changes over time to facilitates progress monitoring and allow early identification of problems. In this context, a multicenter observational study was developed using 3D measurements to monitor the trajectory changes of PI across settings.
Objectives :
1. To monitor the effectiveness of longitudinal tracking of wound healing 2. To examine the impact of 3D wound measurement 3. To evaluate user experience
Methodology :
A prospective observational study was taken to monitor the healing progression of stage 3 and stage 4 PI using 3D wound measurement across clinical and community settings. All participants received standard of care continuously throughout the study. The healing of PI followed a linear trajectory over a 12-week period, as measured by area. Linear regression and Pearson correlation coefficients was used to assessing the variance between 3D and ruler measurements. Intraclass correlation coefficients (ICC) was used to assess wound variance and interrater reliability. Furthermore, a 2-point survey was adopted to examine nurses experience on 3D wound measurements.
Result & Outcome :
A total of 37 participants with stage 3 or 4 PI were enrolled, and 25 were followed for 12 weeks. The skewness of demographic data was found to be -0.8 to 0.8. Wound variance was slight with an ICC at 0.84 and the mean wound area started at 14.54±10.07cm2. The mean percentage area reduction was 15.68±28.4. Linear regression analysis showed that 3D measurement (F=92.99, 95% CI, p < 0.001) has a significant effect on wound progress monitoring although both 3D and ruler measurements given a linear healing slope for each measurement. Interrater reliability was excellent (ICC 0.99, 95% CI 0.98-0.99) while user experience on 3D wound measurement was positive (F 1.30, p = 0.27). Conclusion: 3D measurement demonstrated a significant linear correlation with wound healing progression, aiding decision-making and improved clinical outcomes. It enhances communication across settings and increases user satisfaction. The findings suggested that the HA Smart 2.0 Wound and Packing Module development could benefit from longitudinal tracking based on 3D measurements.
