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  • Ulysse Wilkinson posted an update 1 day, 8 hours ago

    When serum parameters were compared with PU markers, only the PU with the highest DESIGN score was included in the analyses if patients had more than one PU. All between-group differences were analyzed by the Mann�CWhitney U test. All correlations were calculated by Spearman’s rank correlation. For the preliminarily analyses, relationships between nutritional markers in the serum and the wound fluid were determined. Differences in levels of nutritional markers between the inflammatory phase and the proliferative phase were analyzed. In addition, the differences in other confounders, including demographic and nutritional status, were examined. To contrast local and systemic inflammation, correlations between each nutritional marker and CRP were examined. To SCH772984 investigate the relationships between infection and wound fluid properties, a case study with intraindividual comparison was conducted for three patients who had an infected wound and a noninfected wound concurrently. Finally, correlations between the OHP level and each marker were examined. Then, these analyses were evaluated for wounds in the proliferative phase because it was assumed that the OHP level might reflect collagen degradation rather than collagen synthesis during the inflammatory phase. Statistical significant level was set at p-values <0.05. All analyses were conducted by the Statistical Analysis System version 9.1 (SAS Institute Inc., Cary, NC). Thirty-nine patients with 45 PUs were recruited. Of these, 11 patients were excluded, eight patients owing to insufficient wound fluid and three patients owing to continuous topical negative pressure therapy. Therefore, 28 patients were analyzed. Because four patients had two ulcers each, there were 32 PUs. The demographic characteristics of the patients are shown in Table 1. The median DESIGN score was 17 (range 12�C25; Table 2). The most frequent location of PUs was the sacrum (56.3%) followed by the greater trochanter (18.8%). Thirteen wounds (40.6%) were classified as being in the inflammatory phase and 19 (59.4%) were in the proliferative phase. Six wounds (18.8%) were assessed as infected wounds. Albumin, total protein, and glucose levels were significantly lower in the wound fluid than in the serum (all p<0.001, Table 3). The albumin (��=0.74, p<0.001) and total protein level (��=0.54, p=0.010) in wound fluid were positively correlated with the serum level whereas the glucose level was not (��=0.20, p=0.417). Table 3 shows the differences in nutritional markers between the healing phases defined by the clinical definition. There were no significant differences between healing phases in terms of age, sex, Charlson comorbidity score, diabetes, body mass index, and BUN/creatinine ratio (p=0.128�C0.939). Albumin level and A/G ratio in wound fluid were significantly lower in the inflammatory phase than in the proliferative phase (both p=0.003).

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