Hello.

I don't know if there are a tool like you are describing. There are instruments to measure progression to healing (like: PUSH, PSST, DESIGN, RESVECH,...), but al those tools-sacales are for measure when the wound is not healed. After that, I don't know any of it.

If you fins any, please, feedback me. Many thanks in advance.

consult Dr. Gary Sibbald's scale of NERDS & STONEES. It will help you to assess the progression. It is a very comprehensive scale.

Avi,

The two sites below would be a good starting point for you to determine which tool would work best for your research. Good luck!

https://www.atrainceu.com/course-module/1473407-57_assessment-of-wounds-module-08

http://www.npuap.org/resources/educational-and-clinical-resources/push-tool/instructions-for-using-the-push-tool/

NERDS and STONEES is just about describing bioburden, if it's a superficial infection or critical colonization versus a deep or system infection.  It has nothing to do with wound progression, other than reflecting bioburden.

There is at least one scale to assess scar quality. I can't recall the name of it right now, but I've seen it used in the literature.  A search for "scar quality" or something similar should turn it up. Unfortunately, the other scales mentioned, such as the PUSH or BWAT (formerly called PSST) only indicate closure, not the quality of that closure.

Another thought-- the FDA is in the process of revising their guidance document for wounds.  I'm not sure when it's expected to be finalized.  But, we're hoping for a number of possible secondary endpoints to be included.  The AAWC and WHS are spearheading an effort to make that happen.

The most common accepted definition of wound healing I know of, to include CMS definition of a chronic wound, is reduction in size. A wound that reduces in size by half after 4 weeks of standard wound care will heal by 12 weeks. Sheehan is the author of the quoted paper. It has also been an exclusion factor during the washout period in other wound care studies.

Thank you all for trying to assist on this one, and apologies for the late response (holiday season).

Using the FDA guideline (the "old one" , if a new is on the way), a complete closure of a wound can defined as:

Complete wound closure is defined by 100% epithelialization of the wound, in particular: No granulation tissue visible,  No drainage, No sewing material, No need for wound dressing or adjuvants.

Let's assume I use the BWAT score, what numerical score agrees with the definition above ? Can I say the a level below some number will be considered as a complete closure ?

I agree with what Renee said, all the scales mentioned are for closure of a wound, and not for the quality of healing as described by the FDA. I found several scarring scales (Vancouver scale, Manchester scale,...), however I did not find scales for the other two "components" (the contour and the feel of the skin, normalization of the skin markings,...) and definitely not an overall scale for quality of healing. Would you add the scarring as a secondary endpoint ? What I about Valerie's comment, of reduction in size, should it be a secondary endpoint in your opinion, if so, is there an agreed way of measuring the size ?

For measuring size, there are several digital planimetry options, ranging from taking a digital photo, uploading it, and tracing it with specialized software, to special cameras that allow you to note wound margins on the screen, to handsets with lasers to digitally scan the wound.  All will give a much more accurate area or wound perimeter (a meter indicator of healing rate according to some research) than using a ruler for length and width.

You should consider the 'Bates-Jensen Wound Assessment Tool'.