Granulation tissue of chronic pressure ulcers as a predictive indicator of wound closure.

OBJECTIVE

: To describe the temporal relationship between the quantity of granulation tissue in a chronic pressure ulcer (PrU) and its clinical outcome.

DESIGN

: Study participants were seen on days 0, 1, 2, 3, 4, 7, 8, 9, 10, 11, 14, 21, 28, 35, and 42. On each visit, the wounds were digitally photographed with a 3-cm calibration target. Images were analyzed using VeV MD (version 1.1.14; VERG Inc, Winnipeg, Manitoba, Canada) and Adobe Photoshop CS3 Extended (version 10.0.1; Adobe Systems Inc, San Jose, California). Granulation tissue was selected from calibrated digital images by 1 of 2 methods: manual selection and automated selection. Granulation tissue area was expressed as a percentage of total wound area.

SETTING

: Academic research laboratory.

PARTICIPANTS

: Thirty-one chronic PrUs were observed in 27 subjects.

MAIN OUTCOME MEASURES: : Quantitative measure of granulation tissue area.

MAIN

RESULTS

: There was no relationship between the amount of granulation tissue expressed as a percentage of the total PrU area and wound outcome.

CONCLUSIONS

: This study is the first to both quantitatively measure the amount of granulation tissue in a chronic PrU and attempt to correlate it to wound outcome. Although counterintuitive, the amount of granulation tissue was not predictive of outcome, and no temporal trends could be described.