Article

OBJECTIVE: To compare the effects of ultraviolet-C (UVC) with placebo-UVC on
pressure ulcer healing in individuals with spinal cord injury (SCI). DESIGN:
Double-blind randomized trial with stratification for ulcer location to buttock
or lower extremity. Subjects were followed up for 1 year postintervention.
SETTING: Rehabilitation institution. PARTICIPANTS: Adult inpatients and
outpatients (N=43) with SCI and stage 2 to 4 pressure ulcers (n=58).
INTERVENTIONS: Ulcers and periwound skin were irradiated 3 times per week using
UVC or placebo-UVC. The endpoint was wound closure or hospital discharge without
closure. MAIN OUTCOME MEASURES: Primary outcome was weekly percent area relative
to baseline. Secondary outcomes were mean percent area change between consecutive
weeks, surface appearance, weeks to closure, and impact on quality of life and
wound status postintervention. RESULTS: Groups were similar at baseline for all
demographic characteristics except ulcer duration (P=.02). Groups were similar
when healing was compared overall. Subgroup analysis showed that the percent area
relative to baseline for stage 2 buttock ulcers was significantly smaller in the
group receiving UVC compared with placebo at weeks 3, 5, and 7. During weeks 1
through 8, these ulcers were 26% to 76% of baseline area using UVC versus 111% to
180% for placebo (achieved significant level [ASL], .03-.08; effect size,
0.5-0.8). Groups were similar in the percent area relative to baseline for stage
2 lower extremity ulcers. Group mean percent area change between consecutive
weeks for all stage 2 ulcers was 36.6% with the use of UVC and 5.8% for placebo
(ASL=.09). There were no group differences in the percent area relative to
baseline and the mean percent area change between consecutive weeks for stage 3
to 4 ulcers. Groups were similar for all other secondary outcomes. CONCLUSIONS:
UVC is beneficial for stage 2 buttock ulcers. Further studies are warranted using
a larger sample size, carefully considered exclusion criteria, and strategies to
ensure homogeneity of the groups that are being compared.
CI - Copyright (c) 2013 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS