Related Experiment Video
Updated: Aug 12, 2025
Assessment of Acute Wound Healing using the Dorsal Subcutaneous Polyvinyl Alcohol Sponge Implantation and Excisional Tail Skin Wound Models.
Published on: March 25, 2020
Validation of a Wound Tool for Assessment of Surgical Wounds in Infants
Guen Kernaleguen1, Maryna Yaskina, Miriam Fox
1Alberta Health Services, Edmonton, Alberta, Canada (Mss Kernaleguen and Fox); and Women & Children's Health Research Institute (Dr Yaskina), Department of Pediatric Surgery (Dr Dicken), and Department of Pediatrics (Dr van Manen), University of Alberta, Edmonton, Alberta, Canada.
Insights
A new wound assessment tool for neonatal intensive care infants shows promising interrater reliability and criterion validity. Further research is needed to support surgical wound assessment in this vulnerable population.
Area of Science:
- Neonatal intensive care
- Pediatric surgery
- Wound healing research
Background:
- Effective wound assessment is crucial in neonatal intensive care units (NICUs) for timely treatment and prevention of complications.
- Current methods lack validated tools for assessing surgical wounds in infants.
- Early intervention is key to improving surgical wound healing and avoiding adverse outcomes.
Purpose of the Study:
- To develop and validate a tool for assessing surgical wounds in infants.
- To evaluate the tool's interrater reliability, ensuring consistent results across different users.
- To determine the tool's criterion validity by comparing its assessments to expert evaluations.
Main Methods:
- An exploratory cohort study was conducted involving 40 surgical wounds in infants.
- Nursing staff utilized a structured wound assessment tool.
- Wound experts, including a pediatric wound care nurse and a pediatric surgeon, also assessed the wounds.
- Statistical analyses were performed to estimate reliability and validity.
Main Results:
- The developed wound tool demonstrated good interrater reliability, with an intraclass correlation coefficient of 0.775.
- Criterion validity was established, showing a rank correlation coefficient between 0.55 and 0.71.
- A low cutoff score was identified as necessary to achieve 100% sensitivity in distinguishing mild from moderate-severe wounds.
Conclusions:
- While the tool shows potential, wound assessment in infants remains subjective.
- Further research is essential to develop effective strategies for surgical wound assessment in neonates.
- Validated tools are critical for future multi-institutional research in pediatric wound care.
Background:
Wound assessment is a critical part of the care of hospitalized infants in neonatal intensive care. Early recognition and initiation of appropriate treatment of wounds are imperative to facilitate wound healing and avoid complications such as secondary infection and wound dehiscence. There are, however, no validated tools for assessing surgical wounds in infants.
Purpose:
The aim of this study was to develop and interrogate a tool for the assessment of surgical wounds. Specific aims for the tool included interrater reliability (give a consistent and dependable result independent of user) and test criterion validity (give an accurate assessment of the wound compared with an expert).
Methods:
This was an exploratory cohort study involving a structured wound tool applied by nursing staff to 40 surgical wounds. The wounds were also assessed by wound experts (a pediatric wound care nurse and a pediatric surgeon). Comparisons were made to elucidate estimates of reliability and validity.
Results:
The wound tool demonstrated interrater reliability with intraclass correlation coefficient of 0.775 (95% CI, 0.665-0.862) as well as criterion validity with rank correlation coefficient of 0.55 (95% CI, 0.34-0.76) to 0.71 (95% CI, 0.53-0.88). To obtain 100% sensitivity to distinguish mild from moderate-severe wounds, a low cutoff score was needed.
Implications For Practice And Research:
Wound assessment continues to be a subjective exercise, even with the utilization of a tool. Additional research is needed for strategies to support the assessment of surgical wounds in infants. Such tools are needed for future research, particularly when multiple institutions are involved.
