Relationship between maceration and wound healing on diabetic foot ulcers in Indonesia: a prospective study

Abstract

The aim of this study was to clarify the relationship between maceration and wound healing. A prospective longitudinal design was used in this study. The wound condition determined the type of dressings used and the dressing change frequency. A total of 62 participants with diabetic foot ulcers (70 wounds) were divided into two groups: non-macerated (n = 52) and macerated wounds (n = 18). Each group was evaluated weekly using the Bates-Jensen Wound Assessment Tool, with follow-ups until week 4. The Mann-Whitney U test showed that the changes in the wound area in week 1 were faster in the non-macerated group than the macerated group (P = 0·02). The Pearson correlation analysis showed a moderate correlation between maceration and wound healing from enrolment until week 4 (P = 0·002). After week 4, the Kaplan-Meier analysis showed that the non-macerated wounds healed significantly faster than the macerated wounds (log-rank test = 19·378, P = 0·000). The Cox regression analysis confirmed that maceration was a significant and independent predictor of wound healing in this study (adjusted hazard ratio, 0·324; 95% CI, 0·131-0·799; P = 0·014). The results of this study demonstrated that there is a relationship between maceration and wound healing. Changes in the wound area can help predict the healing of wounds with maceration in clinical settings.

The profile of diabetes healthcare professionals in Indonesia: a scoping review

“…; Haryanto et al. ; Pemayun et al. ; Purnamasari & Waspadji ) or intradisciplinary teams (Adriono et al.…”

Identifying, managing and preventing skin maceration: a rapid review of the clinical evidence

“…When searching for papers regarding maceration, the term appears to be ill-defined and usually mentioned only as part of a wider study. However it is clear that maceration is a severe condition that has been shown to cause patients discomfort and pain, 14 as well as prolonging healing time 6 and therefore merits more focused research. There is limited empirical research that is able to inform clinical practice on how to prevent maceration rather than managing the condition once it has already occurred.…”

“…In relation to exuding wounds, Haryanto et al 6 demonstrated that if maceration levels were high then wound healing time also increased. However, Koh et al's 7 earlier study found no significant association between wound duration and hydration scores.…”

Wound Healing Concepts: Contemporary Practices and Future Perspectives

“…Maceration decreases the physical and chemical integrity of the stratum corneum, which acts as a predisposing factor for potential microbial invasion and increased susceptibility to injury by mechanical forces, ultimately leading to enlargement of the wound. Maceration increased susceptibility to mechanical forces and infection [18,19].…”