Stacey MC, Phillips SA, Farrokhyar F, Swaine JM, et al.
Wound repair and regeneration : official publication of the Wound Healing Society [and] the Eur.... Date of publication 2019 Sep 1;volume 27(5):509-518.
1. Wound Repair Regen. 2019 Sep;27(5):509-518. doi: 10.1111/wrr.12723. Epub 2019 May
27.
Evaluation of wound fluid biomarkers to determine healing in adults with venous
leg ulcers: A prospective study.
Stacey MC(1)(2), Phillips SA(1), Farrokhyar F(3), Swaine JM(2)(4).
Author information:
(1)Department of Surgery, McMaster University, Hamilton, Ontario, Canada.
(2)School of Medicine, University of Western Australia, Crawley, Western
Australia, Australia.
(3)Department of Health Research Methods, Evidence, and Impact, McMaster
University, Hamilton, Ontario, Canada.
(4)Institute for Health Research, The University of Notre Dame Australia,
Fremantle, Western Australia, Australia.
Clinical practice guidelines recommend using repeated wound surface area
measurements to determine if a chronic ulcer is healing. This results in delays
in determining the healing status. This study aimed to evaluate whether any of a
panel of biomarkers can determine the healing status of chronic venous leg
ulcers. Forty-two patients with chronic venous leg ulcers had their wound
measured and wound fluid collected at weekly time points for 13 weeks. Wound
fluid was analyzed using multiplex enzyme-linked immunosorbent assay to determine
the concentration of biomarkers in the wound fluid at each weekly time point.
Healing status was determined by examining the change in wound size at the
previous and subsequent weeks. Predictive accuracy with 95% confidence intervals
(CI) is reported. Of 42 patients, 105 evaluable weekly time points were obtained,
with 32 classified as healing, 27 as nonhealing, and 46 as indeterminate.
Thirteen biomarkers significantly differed between healing and nonhealing wounds
(p < 0.1) and were included in a multivariate logistic regression model.
Granulocyte macrophage-colony stimulating factor (p < 0.001) and matrix
metalloprotease-13 (p = 0.004) were the best predictors of wound healing.
Receiver operating characteristic curves indicated 92% accuracy (95% CI:
85%,100%) for granulocyte macrophage-colony stimulating factor, and 78% accuracy
(95% CI: 65%,90%) for matrix metalloprotease-13 in discriminating between healing
and nonhealing wounds. This study found that two biomarkers from wound fluid can
predict healing status in chronic venous leg ulcers. These findings may lead to
the ability to determine the future trajectory of a wound and the ability to
modify treatment accordingly.
© 2019 by the Wound Healing Society.
DOI: 10.1111/wrr.12723
PMID: 31020747
