A wound alkalinity measurement to predict non-healing wound outcomes.
Jon Senkowsky, Shuxin Li, Ashwin Nair and 3 others
PMID 36367802WHAT IT FOUND
At the second visit, alkalinity testing best predicted non-healing in 45 diabetic patients.
An alkaline result was linked to a 96.9% chance of not healing by 12 weeks. The test was not used to guide treatment.
Key findings
01At the second visit, wound alkalinity testing had the highest reported sensitivity (77.5%) and specificity (80.0%) for predicting non-healing at 12 weeks.
02In diabetic patients tested 7 to 21 days after the first visit, an alkaline result was associated with an 82.4% post-test risk of not healing, while a non-alkaline result was associated with a 28.6% risk.
03At the paper's 10% significance threshold, alkalinity and infection status were associated with non-healing, while age, gender and wound type were not.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was single-site and included 96 adults, with small subgroups such as 45 diabetic patients across three visits, 24 patients tested within 7 days, 24 tested 7 to 21 days, and 11 venous stasis plus 13 other wounds tested 7 to 21 days. Device results were not shared with providers and were not used to inform treatment, so the paper does not show that using alkalinity improves care or outcomes. The authors used a 10% significance threshold, and the key sensitivity and specificity differences between visit timing groups were not statistically significant (p = 0.252 and p = 0.529). Wounds with PROMOGRAN PRISMA dressings were not tested, so the device's performance with all common dressings is unknown. The study did not compare the alkalinity test with the usual 4-week 50% wound-size reduction standard. Eligibility required ABI ≥0.6 and excluded pregnancy, cancer, AIDS, hepatitis, short life expectancy and planned major surgery, so results may not apply to more vascular-compromised or medically complex wounds.
Declared interests
No funding or conflicts of interest statement is included in the supplied text.
The easy way to misread this
Do not conclude that wound alkalinity testing improves healing or should replace standard wound assessment. The test results were not shared with providers and were not used to guide treatment, and several accuracy differences were not statistically significant.