Abstract
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.
Keywords
List of abbreviations:
ASL (achieved significance level), PU (pressure ulcer), SCI (spinal cord injury), UV (ultraviolet), UVC (ultraviolet-C)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: December 14, 2012
Footnotes
Supported by the Ontario Neurotrauma Foundation (grant no. SCI-2007-465); Mount Sinai Hospital, Toronto, Canada; and the Toronto Rehabilitation Institute, which receives funding under the Provincial Rehabilitation Research Program from the Ministry of Health and Long-Term Care in Ontario.
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.
ClinicalTrials.gov Identifier: NCT01500174.
Identification
Copyright
© 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
