The association of potential prognostic determinants to nonadherence to negative pressure wound therapy: An exploratory prospective prognostic study.

Autor: Janssen AHJ; Department of Surgery, Elkerliek Hospital, Helmond, The Netherlands. Electronic address: sjanssen@elkerliek.nl., van Bruggen-van der Lugt AW; Master Evidence Based Practice in Healthcare, University of Amsterdam, The Netherlands., Wegdam JA; Department of Surgery, Elkerliek Hospital, Helmond, The Netherlands., de Vries Reilingh TS; Department of Surgery, Elkerliek Hospital, Helmond, The Netherlands., van Dieren S; Department of Surgery, Amsterdam UMC, University of Amsterdam, The Netherlands., Vermeulen H; Scientific Institute for Quality of Healthcare (IQ Healthcare), Radboud University, Nijmegen, The Netherlands; HAN University of Applied Science, Faculty of Health and Social Studies, Institute of Nursing, Nijmegen, The Netherlands. Electronic address: https://twitter.com/hvermeulen67., Eskes AM; Department of Surgery, Amsterdam UMC, University of Amsterdam, The Netherlands; Menzies Health Institute Queensland and School of Nursing and Midwifery, Griffith University, Gold Coast, Australia. Electronic address: https://twitter.com/Anne-Eskes.
Jazyk: angličtina
Zdroj: Surgery [Surgery] 2022 Jul; Vol. 172 (1), pp. 349-357. Date of Electronic Publication: 2022 Mar 02.
DOI: 10.1016/j.surg.2022.01.037
Abstrakt: Background: Up to now it is unclear which determinants influence nonadherence to negative pressure wound therapy. This study aimed to assess the predictive value of prognostic determinants to nonadherence to negative pressure wound therapy.
Methods: A multicenter prospective cohort study on patients with wounds treated with negative pressure wound therapy. Data of 25 potential prognostic determinants of nonadherence were collected using a web-based case record form. Primary outcome was nonadherence to negative pressure wound therapy, defined as premature termination on request of the patient. Logistic regression analyses were used to explore the association between the potential determinants and nonadherence.
Results: Nonadherence to negative pressure wound therapy was found in 32 out of 264 patients (12.1%). Univariable analyses identified 6 candidate prognostic determinants: having sensitive skin (odds ratio 2.32, 95% confidence interval 1.10-5.10, P = .03), decision for negative pressure wound therapy made as a shared decision (odds ratio 2.43, 95% confidence interval 1.06-6.30, P = .05), handiness technique (odds ratio 1.80, 95% confidence interval 0.86-3.89, P = .13), alternatives discussed (odds ratio 1.78, 95% confidence interval 0.83-3.75, P = .13), knowledge and understanding negative pressure wound therapy (odds ratio 0.50, 95% confidence interval 0.18-1.20, P = .15), and previous experience with negative pressure wound therapy (odds ratio 0.42, 95% confidence interval 0.10-1.24, P = .17). In the multivariable analysis, only having sensitive skin appeared to be significant (odds ratio 2.20, 95% confidence interval 1.02-4.85, P = .05).
Conclusion: Patients who have sensitive skin may have an increased risk of premature termination of negative pressure wound therapy. Further research is warranted to determine which strategies are successful to overcome skin irritation problems to avoid nonadherence to negative pressure wound therapy.
(Copyright © 2022 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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