Clinical Applications and Validation of an Innovative Wound Score.

ABSTRACT

OBJECTIVE: This study demonstrates the applicability of an innovative wound score that summates 5 assessments using 2-point (best) to 0-point (worst) grades based on specific findings to generate a 0- to 10-point wound score for categorizing diabetic foot ulcers as well as validates its effectiveness. MATERIALS AND METHODS: Long Beach Wound Scores (LBWS) were determined prospectively over an 18-month period in 105 hospitalized patients, with or without diabetes, with lower extremity wounds. Wounds were categorized as healthy, problem, or end-stage from their initial LBWS. Outcomes were graded as good or poor using a 5-level scale. Outcome information was available and statistically analyzed for comparisons with initial evaluation LBWSs in 85 patients. RESULTS: In the healthy category, 66.7% healed or improved and were designated as good outcomes. In the problem category, 83.3% had good outcomes. In the end-stage category, 50.0% had good outcomes. Outliers for poor outcomes in the healthy category were due to the patients' comorbidities, and good outcomes in the end-stage category were explained by successful revascularizations and/or healing of minor amputations. The accuracy of the LBWS for predicting good versus poor outcomes was 75.3%. CONCLUSIONS: The 0- to 10-point LBWS utilizes objective criteria for grading wounds, has validation data to confirm its efficacy for predicting outcomes, categorizes wound management, and is a practical tool to use for Comparative Effectiveness Research of wound care products and quantifying Minimal Clinically Important Improvement.