@phdthesis{Metelmann2018,
  author    = {Isabella Bettine Metelmann},
  title     = {Velocity of Clinical Wound Healing Without Targeted Treatment Specified for Age, Gender, Body Weight, Skin Type Wound Size and Co‐Morbidities},
  journal    = {Dauer der klinischen Wundheilung - spezifiziert f{\"u}r Alter, Geschlecht, Gewicht, Hauttyp, Wundgr{\"o}{\"s}e und Komorbidit{\"a}ten},
  url       = {https://nbn-resolving.org/urn:nbn:de:gbv:9-opus-25054},
  year      = {2018},
  abstract  = {Introduction Healing of wounds is different in the course of scarring, in influence of risk factors, functional and aesthetic results and velocity. Research endeavours on wound healing aim to identify means to accelerate wound closure. However, there are no extensive clinical data published referring to the time needed for wound healing, more precisely for re-epithelialization without any targeted and specific treatment. The main concern of this study is to learn about, how many days it takes to cover a patient´s wound with epithelial barrier without any specific treatment and how the healing time is modified by individual condition. Herein, we present results of a clinical trial of STSG donor sites concerning the average velocity of epithelial wound healing depending on various factors. Material and Methods Data of the study are part of a phase III multicenter clinical trial with the objective to explore the clinical effectiveness and safety of topical betulin gel in healing of split thickness skin graft donor-site wounds (EudraCT no. 2012-003390-26, EudraCT no. 2012-000777-23). Split thickness skin graft donor site wounds have been divided into two halves. By random decision, one side is treated topically with the substance under investigation, while the other side is left untreated for intra-individual comparison and just covered by an inert standard of care wound dressing. This co-investigation is referring to the outcome of the untreated wound sites only. The assessment was based on photo evaluation by a remote panel of three blinded experts. The protocol is including 198 patients. Statistical analysis was performed with Kaplan-Meier estimates with 95\% confidence intervals, plotting cumulative event rate over time to 95\% epithelialization (days) for several independent variables and logrank test: X2 and P-value. The observation continued to complete closure of the untreated wound or up to 28 days. Results Completion of wound closure is taking at least about 7 days. There are 25\% of patients ahead of the group called fast healers with wound closure by day 11. In 50\% of the patients wound closure has been completed after 14 days of healing. The final 25\% of patients we call late healers presenting wound closure after day 18. Median time to wound closure takes 14 days. Age under 40 years significantly reduces time to wound closure by 2 days while it takes 4 days longer in patients over 60 years of age (P=0). Childbearing potential in females leads to a significant reduction of 4 days (P=0,002). Suffering from cancer or comedication with glucocorticoids lead to a prolongation of 12 and 10 days, respectively (P=0). Summary A superficial skin wound as artificially provoked by dermatomy for STSG without any targeted treatment starts healing after 7 days, is closed in fast healers after 11 days, needs 14 days for re-epithelialization in 50\% of all patients and 18 days in slow healers. Healing is retarded 4 to 12 days extra in patients above 60 years of age, under glucocorticoid medication and suffering from cancer. Healing is getting faster by 2 to 4 days less in younger patients and in pre-menopausal women generally. This follows from the data of 198 patients in 32 hospitals across Europe by common protocol and based upon server-blinded analysis of wound closure by standardized photography.},
  language  = {de}
}