The Effect of the Intentional Wound Care Model Using the 4Ws Principle on Infection Rates and Wound Healing Time in Patients with Chronic Wounds
Keywords:
Intentional wound care, Infection rates, Wound healing time, Chronic woundAbstract
Chronic wounds are a significant health issue that is increasingly prevalent due to the growing number of older adults and individuals with diabetes. This quasi-experimental study aimed to investigate the effects of the Intentional Wound Care Model, utilizing the 4Ws principle, on infection rates and wound healing times in patients with chronic ulcers. The study involved a sample of 70 patients with chronic wounds who were admitted to the surgical department at Phetchabun Hospital. The participants were divided into two groups: the control group received routine wound care, while the experimental group received intentional wound care based on the 4Ws principle.
The research instruments included the intentional wound care guideline based on the 4Ws principle, which encompasses: 1) Wound assessment, 2) Wound care, 3) Wound monitoring, and 4) Wound healing. Additional tools used were the wound recording form, the PUSH Tool, and the TIME framework. Data collection took place from October 2023 to December 2024. The data were analyzed using various statistical methods, including frequency, percentage, mean, standard deviation, chi-square tests, and independent t-tests.
The results indicated that the intentional wound care model using the 4Ws principle significantly reduced the infection rate of chronic ulcers compared to routine wound care (5.7% vs. 25.7%, p = 0.022). Furthermore, it also shortened the wound healing time (2.7 days vs. 9.1 days, 95% CI: 3.0–6.7, p < 0.001) and decreased the length of hospital stay (5.9 days vs. 13.2 days, 95% CI: 2.9–11.6, p = 0.002).
In conclusion, the Intentional Wound Care Model using the 4Ws principle should be implemented in the management of patients with chronic wounds and expanded to community settings. Adopting this model can enhance the effectiveness of wound care for patients transitioning back to the community, promoting faster wound healing and reducing the risk of chronic wound infections.
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