UHMS Members Verify Reliability of Wound Score Tool
Updated assessment scoring improves upon existing systems.
(Based on communications with Dr. Michael Strauss and from the paper “Reliability assessment of an innovative wound score,” by Michael B. Strauss, MD; Hojin Moon, PhD; Jeremy A Busch, DPM; Christopher K. Jones, DPM; Lisa Nhan, DPM; Stuart Miller, MD; Phi-Nga Jeannie Le, MD; Wounds 2016: 28(6); 206-213)
UHMS member Dr. Michael Strauss and his colleagues at Long Beach Memorial Medical Center in Long Beach, California, are no strangers to the war on wounds. Their latest campaign is an updated assessment system developed by taking the best points of several other wound scoring systems and adding features they note will help better define scoring.
Its name: the [Long Beach] Wound Score, or [LB]WS. “The [LB]WS is the first wound scoring system that has reliability and validation data to support its use,” Strauss said in an email communication to the UHMS.
Strauss and colleagues have published a paper that describes the new system: “Reliability assessment of an innovative wound score,” which appeared in the June 2016 issue of Wounds (Wounds 2016; 28(6):206-213). A subsequent article in progress will deal with the validation — i.e., outcome predictions — of the [LB]WS.
A number of wound scoring systems have been devised over the years to evaluate and treat wounds. The [LB]WS system operates before, during and after treatment and helps evaluate effectiveness of protocols in wound therapy.
The [LB]WS utilizes important features of existing systems, including the following:
- the Wagner grade for perfusion assessment
- the National Pressure Ulcer Advisory Panel (NPUAP) for depth assessment
- the University of Texas Health Science Center San Antonio Diabetic Wound Classification (UTDWC) for perfusion and infection plus depth assessments (which utilizes important components of the other three systems)
- the Infectious Disease Society of America (IDSA) Clinical Classification of a Diabetic Foot Infection for infection assessment
The [LB]WS system integrates their most important features and adds two extra parameters. In addition to assessment by depth, degree of infection and perfusion, the [LB]WS adds assessment of wound size and appearance of the wound base to the essential features of the four existing systems. In addition, it grades each assessment on a continuum of severity.
Whereas the older systems are devoted mainly to evaluating diabetic foot ulcer (DFU), the [LB]WS is applicable for non- DFU as well as for those with diabetes who have wounds located in areas other than in the foot.
“The [LB]WS could be a very useful tool for wound management with respect to comparative effectiveness research (CER) — comparing treatment interventions for ‘like-for like’ wounds — and meaningful clinically important improvement, or MCII,” Strauss noted.
“We hope we can begin to answer vital questions as to whether the intervention truly changes the clinical course,” he said. “This has very important ramifications, especially for selection of wound dressing agents as well as hyperbaric oxygen usage.”
Reprinted with permission from the Summer 2016 issue of Pressure, the newsletter of the UHMS; www.uhms.org/ publications/pressure.html.