Relationship Between pH Shifts and Rate of Healing in Chronic Nonhealing Venous Stasis Lower-Extremity Wounds |
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| Affiliation: | 1. MS4, New York College of Podiatric Medicine, New York, NY;2. Endovascular Biostatistician, Icahn School of Medicine at Mount Sinai, New York, NY;3. Associate Researcher, Icahn School of Medicine at Mount Sinai, New York, NY;4. Clinical Associate Professor of Medicine, New York College of Podiatric Medicine, New York, NY;5. Director of Endovascular Intervention of The Mount Sinai Network (Cardiology), Icahn School of Medicine at Mount Sinai, New York, NY;6. PGY2, New York College of Podiatric Medicine, New York, NY;7. Professor of Medicine and Surgery, New York College of Podiatric Medicine, New York, NY;8. Dean of Clinical Education, New York College of Podiatric Medicine, New York, NY;1. Assistant Professor of Community and Preventive Medicine, Bone and Joint Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran;2. General Practitioner, Department of Orthopedic Surgery, Bone and Joint Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran;3. Associate Professor of Orthopedic Surgery and Orthopedic Foot & Ankle Surgeon, Department of Orthopedic Surgery, Bone and Joint Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran;1. Senior Registrar, Department of Orthopedic Surgery and Traumatology, Kolding Hospital, a part of Lillebaelt Hospital, Kolding, Denmark;2. Consultant and Associate Professor, Department of Orthopedic Surgery and Traumatology, Odense University Hospital, Odense, Denmark;3. Consultant and Associate Professor, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark;4. Associate Professor, Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark;5. Consultant, Department of Orthopedic Surgery and Traumatology, Kolding Hospital, a part of Lillebaelt Hospital, Kolding, Denmark;1. Orthopedic Surgeon, Vreden Russian Research Institute of Traumatology and Orthopedics, Ministry of Health of Russia, St. Petersburg, Russia;2. Orthopedic Surgeon, Department of General Surgery, St. Petersburg State University, St. Petersburg, Russia;3. Orthopedic Surgeon, Humanitas Clinical and Research Hospital, Rozzano (Milano), Italy;4. Orthopedic Surgeon, International Center for Limb Lengthening, Rubin Institute for Advanced Orthopedics, Sinai Hospital, Baltimore, Maryland, USA;1. Department of Orthopaedics, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu Province, P.R. China;2. Department of Orthopaedics, People''s Hospital of Gaochun, Nanjing, Jiangsu Province, P.R. China;1. Resident, Postgraduate Year 3, Division of Foot and Ankle Surgery, West Penn Hospital, Allegheny Health Network, Pittsburgh, PA;2. Director of Residency Training, Division of Foot and Ankle Surgery, West Penn Hospital, Allegheny Health Network, Pittsburgh, PA;1. Research Fellow, Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, OH;2. Associate Professor, Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, OH |
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| Abstract: | Venous stasis ulcers represent the majority of lower-extremity ulcers and place a considerable financial burden on the American health care system. Current standard of care therapies remain sub-optimal with 50% of venous stasis ulcers remaining unhealed after 4 months. Sixteen consecutive wounds were enrolled across 8 participants at a single center and underwent pH-driven therapy in addition to standard care as dictated by physicians. Following wound debridement, the pH of the wound bed was measured using pH strips. If acidic, normal saline was used to rinse the wound at every dressing change. If alkaline, nonsterile gauze was soaked in 0.25% acetic acid and applied to the wound for a minimum of 30 seconds. Participants were followed for 4 weeks with research staff observing compliance throughout. All 16 wounds had an alkaline pH at baseline, with an average pH of 8.25 ± 0.55 (range 7.5 to 9). Average area of the wound at the time of enrollment was (mean ± standard deviation) 285.48 ± 43.68 mm2, and average age of the wound was 37.5 ± 20.3 months (range 3 to 72). A simple linear regression model found a moderate relationship between pH and the rate of healing of chronic nonhealing venous stasis lower-extremity wounds (correlation coefficient = 0.61). For every 1-unit change in pH, we can expect to see a change in wound size of 116.05 mm2. This is the first US-based, open-label, prospective study that examined the effect of pH on the rate of healing in chronic nonhealing venous stasis ulcer lowerextremity wounds. |
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