Reliability and validity of DESIGN, a tool that classifies pressure ulcer severity and monitors healing

Sanada, Hiromi; Moriguchi, Tatsurou; Miyachi, Yoshiki; Ohura, Takehiko; Nakajo, Toshio; Tokunaga, K; Fukui, Manabu; Sugama, Junko; Kitagawa, Atsuko

doi:10.12968/jowc.2004.13.1.26564

Cited by 85 publications

(99 citation statements)

References 6 publications

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“…17,23 Several classification tools have also been addressed and supervised tools have been shown to surpass the others. 24,25 In many studies, 2,26,27 assessment of the tissue type is not achieved ͑only the grade or the surface of the wound is provided͒ or is only partially accomplished.…”

Section: Visual Wound Assessmentmentioning

confidence: 99%

Robust tissue classification for reproducible wound assessment in telemedicine environments

Wannous

Treuillet

Lucas

2010

J. Electron. Imaging

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Section: Visual Wound Assessmentmentioning

confidence: 99%

Robust tissue classification for reproducible wound assessment in telemedicine environments

Wannous

Treuillet

Lucas

2010

J. Electron. Imaging

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“…4,22 The tool includes assessment of the depth, exudate, size, infection/ inflammation, granulation tissue, necrotic tissue, and pocketing. The total score is calculated from six items, excluding the depth, and ranges from 0 to 66 points, with higher scores representing more severe PUs.…”

Section: Methods Designmentioning

confidence: 99%

“…Of note, it has been reported that both wound size and pocketing were high intra-class correlation coefficient (r=1). 4 Thus, we evaluated both wound size and pocketing obtained from the clinical notes by WOCNs.…”

Section: Data Collectionmentioning

confidence: 99%

“…1 Once a PU becomes severe, it is likely to progress to a chronic, non-healing PU. Although there are several staging systems, such as those by Shea, 2 the National Pressure Ulcer Advisory Panel, 3 and the Japanese Society of Pressure Ulcers, 4 the depth of PUs and damage to deep tissue are only classified by visual inspection. In general, severe PUs are defined as those causing full-thickness skin loss and categorized as stage III, IV (Table 1).…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of an advanced pressure ulcer management protocol followed by trained wound, ostomy, and continence nurses: a non-randomized controlled trial

Kaitani¹,

Nakagami²,

Sugama³

et al. 2015

CWCMR

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Aims and objectives:We investigated the effectiveness and safety of an advanced pressure ulcer (PU) management protocol comprising 1) ultrasonography to assess the deep tissue, 2) use of a non-contact thermometer to detect critical colonization, 3) conservative sharp debridement, 4) dressing selection, 5) negative pressure wound therapy, and 6) vibration therapy in comparison with those of a conventional approach. Each protocol was followed by trained wound, ostomy, and continence nurses (WOCNs). Background: At present, there is no systematic PU management protocol for nurses that includes appropriate assessment and intervention techniques for deep tissue injury and critical colonization. In Japan, there is no such protocol that the nurses can follow without a physician's orders. Design and methods: This was a prospective non-randomized controlled trial. Over a 3-week period, we evaluated the effectiveness of an advanced protocol by comparing the PU severity and healing on the basis of the DESIGN-R scale and presence of patients' discomfort. We recruited ten WOCNs to follow the advanced protocol and 19 others as controls. Statistical analysis included a linear mixed-effects model and a logistic regression model. Results: In week 0-1, the advanced protocol was significantly associated with prevention of PU deterioration. Using the linear mixed-effects model, we observed a greater decrease in the DESIGN-R score (healing) in the advanced protocol group. There were no reports of excessive bleeding, pain or infection with the advanced protocol. Conclusion: Using the advanced protocol, WOCNs detected PU severity, assessed PUs, and treated PUs safely. This protocol prevented PU deterioration and/or facilitated wound healing. Relevance to clinical practice: With proper training, WOCNs can assess and treat PUs safer and quicker than when a physician's assessment is required, leading to an improvement in wound healing and prevention of PU deterioration.

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“…However, none of them has dealt with the problem of automated lesion classification. For example [4] proposes a tool using images for classifying the pressure ulcer and for healing monitoring but the related data are entered manually and the classification is done manually as well. In [5] the lesions are measured from photos using a 3D acquisition system employing a pattern-projecting device, so that the spatial data can be extracted, but the automated lesion classification problem is not handled.…”

mentioning

confidence: 99%

Automated Pressure Ulcer Lesion Diagnosis for Telemedicine Systems

Kosmopoulos

Tzevelekou

2007

IEEE Eng. Med. Biol. Mag.

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The timely diagnosis and treatment of pressure ulcers is a critical task and constitutes a challenge in patient rehabilitation. In this work we investigate how a tool for automated pressure ulcer stage classification can be integrated into an asynchronous telemedicine system aiming to increase efficiency and monitoring capabilities for large volumes of patient data. The deployment requirements, the internal architecture as well as the employed techniques are outlined. Furthermore, the initial processing results are provided to demonstrate the feasibility of automated classification of pressure ulcer regions in various grades.

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Reliability and validity of DESIGN, a tool that classifies pressure ulcer severity and monitors healing

Abstract: Based on our results, DESIGN was found to have both high inter-rater reliability and high validity among the seven nurses who quantitatively evaluated the wound-healing progress of the pressure ulcers in this study.

Cited by 85 publications

References 6 publications

Robust tissue classification for reproducible wound assessment in telemedicine environments

Robust tissue classification for reproducible wound assessment in telemedicine environments

Evaluation of an advanced pressure ulcer management protocol followed by trained wound, ostomy, and continence nurses: a non-randomized controlled trial

Automated Pressure Ulcer Lesion Diagnosis for Telemedicine Systems

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