TY - JOUR
T1 - The association of potential prognostic determinants to nonadherence to negative pressure wound therapy
T2 - An exploratory prospective prognostic study
AU - Janssen, Alexandra H. J.
AU - van Bruggen-van der Lugt, Andrea W.
AU - Wegdam, Johannes A.
AU - de Vries Reilingh, Tammo S.
AU - van Dieren, Susan
AU - Vermeulen, Hester
AU - Eskes, Anne M.
N1 - Funding Information:
The authors wish to thank the (wound care) specialists of the Bernhoven Hospital Uden, Canisius-Wilhelmina Hospital Nijmegen, Catharina Hospital Eindhoven, Da Vinci Clinic Geldrop, Elisabeth Hospital Tilburg, Elkerliek Hospital Helmond, Haaglanden Medical Center Den Haag, Hyperbaric Medical Centre Rijswijk, Máxima Medical Center Eindhoven, Reinier de Graaf Hospital Delft, Rijnstate Hospital Arnhem, Sint Anna Hospital Geldrop, Sint Jans Gasthuis Weert, Radboudumc Nijmegen, VieCuri Hospital venlo, and ZorgSaam Hospital Terneuzen for data collection of this study.
Publisher Copyright:
© 2022 Elsevier Inc.
PY - 2022/7
Y1 - 2022/7
N2 - 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.
AB - 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.
UR - https://www.scopus.com/pages/publications/85125640913
U2 - 10.1016/j.surg.2022.01.037
DO - 10.1016/j.surg.2022.01.037
M3 - Article
C2 - 35248365
SN - 0039-6060
VL - 172
SP - 349
EP - 357
JO - Surgery (United States)
JF - Surgery (United States)
IS - 1
ER -