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Status: Bibliographieeintrag

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Verfasst von:Siegwart, Laura [VerfasserIn]   i
 Böcker, Arne Hendrik [VerfasserIn]   i
 Diehm, Yannick [VerfasserIn]   i
 Kotsougiani-Fischer, Dimitra [VerfasserIn]   i
 Erdmann, Stella [VerfasserIn]   i
 Ziegler, Benjamin [VerfasserIn]   i
 Kneser, Ulrich [VerfasserIn]   i
 Hirche, Christoph [VerfasserIn]   i
 Fischer, Sebastian [VerfasserIn]   i
Titel:Enzymatic debridement for burn wound care
Titelzusatz:interrater reliability and impact of experience in post-intervention therapy decision
Verf.angabe:Laura C. Siegwart, MD, Arne H. Böcker, MD, Yannick F. Diehm, MD, Dimitra Kotsougiani-Fischer, MD, Stella Erdmann, MSc, Benjamin Ziegler, MD, Ulrich Kneser, MD, Christoph Hirche, MD, and Sebastian Fischer, MD
Jahr:2021
Umfang:9 S.
Fussnoten:Published: 30 December 2020 ; Gesehen am 17.11.2021
Titel Quelle:Enthalten in: Journal of burn care & research
Ort Quelle:Philadelphia, Pa. : Lippincott Williams & Wilkins, 1980
Jahr Quelle:2021
Band/Heft Quelle:42(2021), 5 vom: Sept./Okt., Seite 953-961
ISSN Quelle:1559-0488
Abstract:Enzymatic debridement (ED) has become a reliable tool for eschar removal. Although ED application is simple, wound bed evaluation and therapy decision post-intervention are prone to subjectivity and failure. Experience in ED might be the key, but this has not been proven yet. The aim of this study was to assess interrater reliability (IR) in post-intervention wound bed evaluation and therapy decision as well as the impact of experience. In addition, the authors introduce video assessment as a valuable tool for post-ED decision-making and education. A video-based survey was conducted among physicians with various experiences in ED. The survey involved multiple-choice and 5-point Likert scale questions about professional status, experience in ED, confidence in post-ED wound bed evaluation, and therapy decision. Subsequently, videos of 15 mixed pattern to full-thickness burns immediately after removal of the enzyme complex were demonstrated. Participants were asked for evaluation of each burn wound, including bleeding pattern and consequent therapy decision. IR ≥ 80% was considered as a consensus. Responses were stratified according to participants’ experience in applying ED (<10, 10-19, 20-49, and ≥50 applications). IR was assessed by chi-square test (raw agreement [RA]; ≥80% was considered as a consensus) and by calculation of Krippendorff’s alpha. In addition, expert consensus for therapy decision was compared with the actual clinical course of each shown patient. Last, participants were asked for their opinion on video as an assessment tool for post-ED wound bed evaluation, decision-making, and training. Thirty-one physicians from 11 burn centers participated in the survey. The overall consensus (raw agreement [RA] ≥ 80%) in post-ED wound bed evaluation and therapy decision was achieved in 20 and 40%, respectively. Krippendorff’s alpha is given by 0.32 (95% confidence interval: 0.15, 0.49) and 0.31 (95% confidence interval: 0.16, 0.47), respectively. Subgroup analysis revealed that physicians with high experience in ED achieved significantly more consensus in post-intervention wound bed evaluation and therapy decision compared with physicians with moderate experience (60 vs 13.3%; P = .02 and 86.7 vs 33.3%; P = .04, respectively). Video analysis was considered a feasible (90.3%) and beneficial (93.5%) tool for post-intervention wound bed evaluation and therapy decision as well as useful for training purposes (100%). Reliability of wound bed evaluation and therapy decision after ED depends on the experience of the rating physician. Video analysis is deemed to be a valuable tool for ED evaluation, decision-making, and user training.
DOI:doi:10.1093/jbcr/iraa218
URL:Bitte beachten Sie: Dies ist ein Bibliographieeintrag. Ein Volltextzugriff für Mitglieder der Universität besteht hier nur, falls für die entsprechende Zeitschrift/den entsprechenden Sammelband ein Abonnement besteht oder es sich um einen OpenAccess-Titel handelt.

Volltext: https://doi.org/10.1093/jbcr/iraa218
 DOI: https://doi.org/10.1093/jbcr/iraa218
Datenträger:Online-Ressource
Sprache:eng
K10plus-PPN:1777657946
Verknüpfungen:→ Zeitschrift

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