Risk Factors for Non-Healing Wounds—A Single-Centre Study

Author:

Wolny Daniel12,Štěpánek Ladislav1ORCID,Horáková Dagmar1,Thomas Janet1,Zapletalová Jana3,Patel Mihir Sanjay1

Affiliation:

1. Department of Public Health, Faculty of Medicine and Dentistry, Palacký University Olomouc, Hněvotínská 976/3, 775 15 Olomouc, Czech Republic

2. Department of Surgery, Military Hospital Olomouc, Sušilovo Náměstí 5, 771 11 Olomouc, Czech Republic

3. Department of Biophysics, Faculty of Medicine and Dentistry, Palacký University Olomouc, Hněvotínská 976/3, 775 15 Olomouc, Czech Republic

Abstract

Background: Chronic wounds present a significant clinical, social, and economic challenge. This study aimed to objectify the risk factors of healing outcomes and the duration of chronic wounds from various etiologies. Methods: Patients treated for non-healing wounds at the surgical outpatient clinic of the Olomouc Military Hospital were involved. Data from patients treated between 8/2021 and 9/2023 were selected. Patients were mostly treated as outpatients, with microbiological follow-up indicated in cases of advanced signs of inflammation. Results: There were 149 patients who met our selection criteria (the mean age was 64.4 years). Predominant causes of wounds involved diabetes (30.9%), post-trauma (25.5%), pressure ulcers (14.8%), surgical site infections (14.8%), and vascular ulcers (14.1%). Patient outcomes included wound resolution in 77.2% of patients (with a mean healing time of 110.9 days), amputation in 14.1%, and wound-related death in 8.7% of patients. Non-healing cases (amputation/death) were predicted by several local factors including an initial depth greater than 1 cm, wound secretion, inflammatory base, and a maximum wound size. Systemic factors included most strongly clinically manifested atherosclerosis and its risk factors. Of the 110 swabs performed, 103 identified at least 1 bacterial genus. The dominant risk factor for a prolonged healing duration was bacterial infection. Wounds contaminated by Proteus or Pseudomonas had prolonged healing times of 87 days (p = 0.02) and 72 days (p = 0.045), respectively. Conclusions: The early identification of local and systemic risk factors contributes to the successful resolution of chronic wounds and a reduced duration of healing.

Funder

Palacký University Fund

Publisher

MDPI AG

Reference29 articles.

1. International Diabetes Federation (2023, December 09). IDF Diabetes Atlas 2021. Available online: https://diabetesatlas.org/atlas/tenth-edition/.

2. Wound Infections: An overview;Williams;Br. J. Community Nurs.,2021

3. Human Wound and Its Burden: Updated 2020 Compendium of Estimates;Sen;Adv. Wound Care,2021

4. Vascular assessment of wound healing: A clinical review;William;Int. Wound J.,2017

5. Chronic Wounds: Evaluation and Management;Bowers;Am. Fam. Physician,2020

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