Functional and Clinical Outcomes in Acute Wound Management: Measuring the Impact of Negative Pressure Wound Therapy and Specialized Physical Therapy
Abstract
1. Introduction
2. Materials and Methods
2.1. Study Design and Settings
2.2. Inclusion and Exclusion Criteria
2.3. Data Collection and Questionnaires
2.4. Statistical Analysis
3. Results
3.1. Patient Demographics
3.2. Evolution of Functional Parameters
3.3. Analysis of Quality of Life Questionnaires and Functional Parameters
4. Discussion
4.1. Analysis of Literature
4.2. Study Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Characteristics | NPWT (n = 110) | NPWT+FNP (n = 82) | p-Value | Cohen’s d |
---|---|---|---|---|
Age, years | 37.86 ± 4.53 | 36.54 ± 5.50 | 0.069 | 0.28 |
Sex, men (%) | 58 (52.7%) | 47 (57.3%) | 0.063 | |
Overweight (>25.0 kg/m2) | 51 (46.36%) | 54 (56.84%) | 0.103 | |
Smoking | 43 (39.1%) | 31 (37.8%) | 0.717 | |
CCI > 2 | 2 (1.81%) | 2 (2.4%) | 0.554 | |
Wound type | 0.688 | |||
| 41 (37.3%) | 27 (32.9%) | ||
| 47 (42.7%) | 41 (50%) | ||
| 22 (20%) | 14 (17.1%) |
Variables | NPWT (n = 110) | NPWT+FNP (n = 82) | p-Value | Cohen’s d |
---|---|---|---|---|
Dorsiflexion (°)—10 days | 10.05 ± 1.76 | 18.10 ± 1.63 | <0.001 | 4.65 |
Plantar flexion (°)—10 days | 29.58 ± 2.42 | 45.13 ± 2.56 | <0.001 | 5.98 |
Knee flexion (°)—10 days | 115.57 ± 5.32 | 134.58 ± 5.15 | <0.001 | 3.50 |
Pronation (°)—10 days | 11.40 ± 2.16 | 18.06 ± 2.12 | <0.001 | 3.10 |
Supination (°)—10 days | 20.22 ± 2.56 | 33.24 ± 2.65 | <0.001 | 4.90 |
Dorsiflexion (°)—42 days | 15.12 ± 1.73 | 23.10 ± 1.64 | <0.001 | 4.75 |
Plantar flexion (°)—42 days | 35.56 ± 2.48 | 54.05 ± 1.54 | <0.001 | 6.73 |
Knee flexion (°)—42 days | 130.01 ± 4.49 | 141.42 ± 3.74 | <0.001 | 2.68 |
Pronation (°)—42 days | 16.61 ± 1.59 | 18.06 ± 2.12 | 0.001 | 0.74 |
Supination (°)—42 days | 27.90 ± 2.25 | 33.24 ± 2.65 | 0.980 | 0.01 |
Dorsiflexion (°)—180 days | 18.15 ± 1.86 | 23.10 ± 1.64 | <0.001 | 2.75 |
Plantar flexion (°)—180 days | 44.60 ± 2.73 | 54.05 ± 1.54 | <0.001 | 4.20 |
Knee flexion (°)—180 days | 135.59 ± 4.52 | 141.42 ± 3.74 | <0.001 | 1.40 |
Pronation (°)—180 days | 18.11 ± 1.63 | 18.06 ± 2.12 | 0.838 | 0.03 |
Supination (°)—180 days | 33.42 ± 2.31 | 33.24 ± 2.65 | 0.618 | 0.07 |
Variables | NPWT (n = 110) | NPWT+FNP (n = 82) | p-Value | Cohen’s d |
---|---|---|---|---|
Calf circumference (cm)—10 days | 37.48 ± 1.84 | 37.06 ± 1.79 | 0.115 | 0.23 |
Edema circumference (cm)—10 days | 41.15 ± 2.39 | 40.36 ± 2.32 | 0.023 | 0.33 |
Edema depth (mm)—10 days | 1.49 ± 0.8 | 1.50 ± 0.69 | 0.957 | 0.01 |
Calf circumference (cm)—42 days | 36.28 ± 1.8 | 36.39 ± 1.75 | 0.695 | 0.06 |
Edema circumference (cm)—42 days | 37.49 ± 1.84 | 37.06 ± 1.80 | 0.115 | 0.23 |
Edema depth (mm)—42 days | 0.9 ± 0.042 | 0.50 ± 0.23 | <0.001 | 1.21 |
Calf circumference (cm)—180 days | 35.23 ± 1.79 | 36.28 ± 1.76 | <0.001 | 0.59 |
Edema circumference (cm)—180 days | 36.29 ± 1.8 | 36.39 ± 1.75 | 0.695 | 0.06 |
Edema depth (mm)—180 days | 0.53 ± 0.24 | 0.19 ± 0.14 | <0.001 | 1.69 |
Variables | NPWT (n = 110) | NPWT+FNP (n = 82) | p-Value | Cohen’s d |
---|---|---|---|---|
Initial MMT tibialis anterior | 3.27 ± 0.67 | 3.08 ± 0.68 | 0.058 | 0.28 |
Initial MMT triceps surae | 3.46 ± 0.67 | 3.18 ± 0.64 | 0.004 | 0.43 |
MMT tibialis anterior—10 days | 3.60 ± 0.66 | 4.02 ± 0.69 | <0.001 | 0.63 |
MMT triceps surae—10 days | 3.88 ± 0.67 | 4.13± 0.63 | 0.007 | 0.38 |
MMT tibialis anterior—42 days | 4.14 ± 0.60 | 4.69 ± 0.48 | <0.001 | 1.02 |
MMT triceps surae—42 days | 4.41 ± 0.53 | 4.82 ± 0.41 | <0.001 | 0.86 |
MMT tibialis anterior—180 days | 4.83 ± 0.37 | 4.96 ± 0.19 | 0.003 | 0.48 |
MMT triceps surae—180 days | 4.95 ± 0.23 | 4.98 ± 0.16 | 0.303 | 0.16 |
Variables | NPWT (n = 110) | NPWT+FNP (n = 82) | p-Value | Cohen’s d |
---|---|---|---|---|
Physical domain—10 days | 27.17 ± 5.83 | 39.30 ± 5.56 | <0.001 | 2.15 |
Physical domain—42 days | 55.52 ± 7.44 | 70.45 ± 6.88 | <0.001 | 2.06 |
Physical domain—180 days | 85.12 ± 5.41 | 94.53 ± 5.07 | <0.001 | 1.77 |
Psychological domain—10 days | 45.04 ± 6.14 | 54.78 ± 6.12 | <0.001 | 1.61 |
Psychological domain—42 days | 64.98 ± 5.96 | 74.13 ± 5.33 | <0.001 | 1.63 |
Psychological domain—180 days | 85.74 ± 5.37 | 95.06 ± 4.87 | <0.001 | 1.83 |
Social domain—10 days | 49.93 ± 6.11 | 59.21 ± 5.36 | <0.001 | 1.64 |
Social domain—42 days | 65.84 ± 7.03 | 77.02 ± 7.22 | <0.001 | 1.59 |
Social domain—180 days | 91.61 ± 5.05 | 97.66 ± 3.07 | <0.001 | 1.44 |
Mean score—10 days | 59.89 ± 5.86 | 69.24 ± 5.92 | <0.001 | 1.59 |
Mean score—42 days | 72.47 ± 6.86 | 82.02 ± 7.23 | <0.001 | 1.37 |
Mean score—180 days | 93.40 ± 3.95 | 98.99 ± 1.59 | <0.001 | 1.67 |
Variables | NPWT (n = 110) | NPWT+FNP (n = 82) | p-Value | Cohen’s d |
---|---|---|---|---|
SF-36 score—10 days | 40.54 ± 5.78 | 49.40 ± 6.26 | <0.001 | 1.51 |
SF-36 score—42 days | 61.44 ± 7.2 | 72.69 ± 7.06 | <0.001 | 1.59 |
SF-36 score—180 days | 85.60 ± 5.35 | 94.21 ± 5.19 | <0.001 | 1.77 |
Variables | NPWT (n = 110) | NPWT+FNP (n = 82) | p-Value | Cohen’s d |
---|---|---|---|---|
Anxiety score—10 days | 13.14 ± 2.39 | 10.64 ± 2.38 | <0.001 | 1.05 |
Anxiety score—42 days | 7.93 ± 1.89 | 5.13 ± 1.83 | <0.001 | 1.48 |
Anxiety score—180 days | 4.44 ± 1.35 | 2.08 ± 1.43 | <0.001 | 1.68 |
Depression score—10 days | 10.87 ± 2.31 | 8.36 ± 2.30 | <0.001 | 1.09 |
Depression score—42 days | 6.95 ± 1.89 | 4.32 ± 1.70 | <0.001 | 1.43 |
Depression score—180 days | 3.74 ± 1.42 | 1.33 ± 1.27 | <0.001 | 1.66 |
Variables | NPWT (n = 110) | NPWT+FNP (n = 82) | p-Value | Cohen’s d |
---|---|---|---|---|
VAS score—10 days | 6.7 ± 1.05 | 5.52 ± 1.01 | <0.001 | 1.14 |
VAS score—42 days | 3.31 ± 1.34 | 1.35 ± 1.03 | <0.001 | 1.63 |
VAS score—180 days | 0.05 ± 0.31 | 0 ± 0 | 0.137 | 0.19 |
Time | Variable | Correlated Outcome | Coefficient (r) | p-Value |
---|---|---|---|---|
10 Days | MMT tibialis anterior | SF-36 | 0.090 | 0.214 |
10 Days | MMT triceps surae | SF-36 | 0.012 | 0.870 |
10 Days | MMT tibialis anterior | WHOQOL-BREF | 0.162 | 0.025 |
10 Days | MMT triceps surae | WHOQOL-BREF | 0.056 | 0.438 |
10 Days | MMT tibialis anterior | HADS Anxiety | −0.089 | 0.221 |
10 Days | MMT triceps surae | HADS Anxiety | −0.113 | 0.117 |
10 Days | MMT tibialis anterior | VAS | −0.203 | 0.005 |
10 Days | MMT triceps surae | VAS | −0.138 | 0.056 |
10 Days | Pronation | SF-36 | −0.248 | 0.001 |
10 Days | Pronation | WHOQOL-BREF | 0.517 | <0.001 |
10 Days | Pronation | HADS Anxiety | −0.381 | <0.001 |
10 Days | Pronation | VAS | −0.460 | <0.001 |
10 Days | Supination | SF-36 | 0.560 | <0.001 |
10 Days | Supination | WHOQOL-BREF | 0.596 | <0.001 |
10 Days | Supination | HADS Anxiety | −0.450 | <0.001 |
10 Days | Supination | VAS | −0.476 | <0.001 |
10 Days | Edema circumference | SF-36 | −0.011 | 0.879 |
10 Days | Edema circumference | WHOQOL-BREF | −0.049 | 0.497 |
10 Days | Edema circumference | HADS Anxiety | 0.070 | 0.334 |
10 Days | Edema circumference | VAS | 0.165 | 0.023 |
6 Weeks | MMT tibialis anterior | SF-36 | 0.231 | 0.001 |
6 Weeks | MMT triceps surae | SF-36 | 0.195 | 0.007 |
6 Weeks | MMT tibialis anterior | WHOQOL-BREF | 0.218 | 0.002 |
6 Weeks | MMT triceps surae | WHOQOL-BREF | 0.207 | 0.004 |
6 Weeks | MMT tibialis anterior | HADS Anxiety | −0.210 | 0.004 |
6 Weeks | MMT triceps surae | HADS Anxiety | −0.170 | 0.019 |
6 Weeks | MMT tibialis anterior | VAS | −0.303 | <0.001 |
6 Weeks | MMT triceps surae | VAS | −0.260 | <0.001 |
6 Weeks | Pronation | SF-36 | 0.355 | <0.001 |
6 Weeks | Pronation | WHOQOL-BREF | 0.093 | 0.198 |
6 Weeks | Pronation | HADS Anxiety | −0.310 | <0.001 |
6 Weeks | Pronation | VAS | −0.365 | <0.001 |
6 Weeks | Supination | SF-36 | 0.451 | <0.001 |
6 Weeks | Supination | WHOQOL-BREF | 0.429 | <0.001 |
6 Weeks | Supination | HADS Anxiety | −0.451 | <0.001 |
6 Weeks | Supination | VAS | −0.448 | <0.001 |
6 Weeks | Edema circumference | SF-36 | −0.179 | 0.013 |
6 Weeks | Edema circumference | WHOQOL-BREF | −0.076 | 0.295 |
6 Weeks | Edema circumference | HADS Anxiety | 0.153 | 0.034 |
6 Weeks | Edema circumference | VAS | 0.168 | 0.020 |
6 Months | MMT tibialis anterior | SF-36 | 0.205 | 0.004 |
6 Months | MMT triceps surae | SF-36 | 0.032 | 0.656 |
6 Months | MMT tibialis anterior | WHOQOL-BREF | 0.076 | 0.297 |
6 Months | MMT triceps surae | WHOQOL-BREF | −0.010 | 0.887 |
6 Months | MMT tibialis anterior | HADS Anxiety | −0.117 | 0.105 |
6 Months | MMT triceps surae | HADS Anxiety | 0.017 | 0.820 |
6 Months | MMT tibialis anterior | VAS | 0.036 | 0.619 |
6 Months | MMT triceps surae | VAS | 0.026 | 0.720 |
6 Months | Pronation | SF-36 | −0.017 | 0.814 |
6 Months | Pronation | WHOQOL-BREF | 0.044 | 0.543 |
6 Months | Pronation | HADS Anxiety | 0.073 | 0.312 |
6 Months | Pronation | VAS | −0.024 | 0.738 |
6 Months | Supination | SF-36 | −0.044 | 0.544 |
6 Months | Supination | WHOQOL-BREF | −0.053 | 0.461 |
6 Months | Supination | HADS Anxiety | −0.036 | 0.621 |
6 Months | Supination | VAS | −0.086 | 0.238 |
6 Months | Edema circumference | SF-36 | 0.057 | 0.435 |
6 Months | Edema circumference | WHOQOL-BREF | 0.051 | 0.486 |
6 Months | Edema circumference | HADS Anxiety | −0.088 | 0.226 |
6 Months | Edema circumference | VAS | 0.084 | 0.249 |
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Stanciu, C.-T.; Vermesan, D.; Pop, D.L.; Hogea, B.; Vlad, S.V. Functional and Clinical Outcomes in Acute Wound Management: Measuring the Impact of Negative Pressure Wound Therapy and Specialized Physical Therapy. Life 2025, 15, 511. https://doi.org/10.3390/life15040511
Stanciu C-T, Vermesan D, Pop DL, Hogea B, Vlad SV. Functional and Clinical Outcomes in Acute Wound Management: Measuring the Impact of Negative Pressure Wound Therapy and Specialized Physical Therapy. Life. 2025; 15(4):511. https://doi.org/10.3390/life15040511
Chicago/Turabian StyleStanciu, Cristina-Teodora, Dinu Vermesan, Daniel Laurentiu Pop, Bogdan Hogea, and Silviu Valentin Vlad. 2025. "Functional and Clinical Outcomes in Acute Wound Management: Measuring the Impact of Negative Pressure Wound Therapy and Specialized Physical Therapy" Life 15, no. 4: 511. https://doi.org/10.3390/life15040511
APA StyleStanciu, C.-T., Vermesan, D., Pop, D. L., Hogea, B., & Vlad, S. V. (2025). Functional and Clinical Outcomes in Acute Wound Management: Measuring the Impact of Negative Pressure Wound Therapy and Specialized Physical Therapy. Life, 15(4), 511. https://doi.org/10.3390/life15040511