Quantifying Burn Wound Healing and Episode Costs

The objectives of this competitive continuation application which utilizes a descriptive correlational design are to: 1) determine the clinical usefulness and reliability of two methods for measuring burn wound healing during hospitalization; 2) examine the impact of variables that significantly affect wound healing; 3) correlate these variables with the cost of inpatient treatment as well as the rate of wound healing; and 4) recommend a model protocol for quantifying wound healing in future intervention studies. The two methods to be utilized to quantify wound healing are subjecting photographs to computerized image analysis to determine the total wound area and calculating, from photographs and clinical observation, a "burn wound severity score" (BWSS). Correlates to wound healing which will be examined in this study include nosocomial infection, pre- and post-burn nutritional status, pre- and post- burn psychological stress, demographics, past medical history, adequacy of immediate post-burn care, total body surface burned, burn depth and anatomical location of burns.

Sixty burn subjects who are treated as inpatients at a university burn center will participate. In addition to periodic clinical assessment, each subject's wounds will be photographed using a standard protocol at baseline and thereafter at regular intervals. Physiologic and psychometric methods and clinical observations will be utilized to examine correlates to wound healing. All proposed physiologic tests and psychometric instruments have established reliability and validity.

Multiple regression procedures will be used to explore the relationship between possible predictors of burn wound healing, and 1) change in total wound area, 2) change in BWSS, and 3) cost per patient. Additionally, since the rate of wound healing may impact cost of care, the relationship between the two measures of wound healing, change in total wound area and change in BWSS Score, and cost per patient will be explored utilizing regression techniques.

Currently, there is no standardized technique for quantifying wound healing and the role of wound healing correlates and costs attributable to burn wound healing are either controversial or incompletely investigated in the literature. This protocol for measuring wound healing may ultimately be applicable to all types of surgical, traumatic and/or chronic wounds. Examination of wound healing correlates and costs of burn treatment will add to the extant body of knowledge.

Final report is available on NTRL: https://ntrl.ntis.gov/NTRL/dashboard/searchResults/titleDetail/PB2010103...