Active topical therapy by "Furuta method" for effective pressure ulcer treatment: A retrospective study

Abstract

Background: We newly proposed that "Furuta method," a pharmacist intervention guidelines, is a topical ointment therapy that considers the physical properties and moist environment of wounds for pressure ulcer (PU) treatment. The aim of this multicenter retrospective study was to investigate the effectiveness of this method for PU. Methods: A total of 888 consecutive patients who underwent treatment for PU at 37 hospitals and five dispensing pharmacies in Japan between August 2010 and July 2014 were included in the study. Based on a survey on compliance to "Furuta method," single-blind allocation was conducted into compliance (n = 437) and non-compliance (n = 451) groups, followed by a retrospective data collection. The primary and secondary outcomes were the healing period and rates of unhealed wounds, respectively. Data was expressed as mean ± standard deviation. Two-sided log rank tests were used for between-group comparisons of PU progression, whereas Kaplan-Meier plots were used for comparison between groups. We performed rigorous adjustment for marked differences in baseline patient characteristics by propensity score (PS) matching. Results: After PS matching, patients were categorized as DESIGN-R d2 (n = 202), D3 (n = 130), D4 and 5 (n = 76), and DU (n = 76). In terms of the healing period, the patients in the compliance groups healed faster than those in the non-compliance groups in d2 (23.6 ± 36.8 vs. 32.2 ± 16.6 days; P < 0.001), D3 (46.8 ± 245.5 vs.137.3 ± 52.7 days; P < 0.001), and D4, 5 (122.5 ± 225.7 vs. 258.2 ± 292.7 days; P < 0.001). There were significantly lesser events of PU progression in the compliance group than in the non-compliance group (15 vs. 54; P = 0.003). Conclusions: "Furuta method" is the new therapeutic strategy of PU, a pharmacist intervention guidelines, may possibly increase healing rates of PUs.