Development and validation of an algorithm for laser application in wound treatment

Methodological study and literature review. For the development of the algorithm, a review was performed in the Health Sciences databases of the past ten years. The algorithm evaluation was performed by 24 participants, nurses, physiotherapists, and physicians. For data analysis, the Cronbach’s alpha coefficient and the chi-square test for independence was used. The level of significance of the statistical test was established at 5% (p<0.05).

Results:

The professionals’ responses regarding the facility to read the algorithm indicated: 41.70%, great; 41.70%, good; 16.70%, regular. With regard the algorithm being sufficient for supporting decisions related to wound evaluation and wound cleaning, 87.5% said yes to both questions. Regarding the participants’ opinion that the algorithm contained enough information to support their decision regarding the choice of laser parameters, 91.7% said yes. The questionnaire presented reliability using the Cronbach’s alpha coefficient test (α = 0.962).

Conclusion:

The developed and validated algorithm showed reliability for evaluation, wound cleaning, and use of laser therapy in wounds.

Descriptors:
Wounds and Injuries; Wound Healing; Lasers; Protocols; Algorithms

Escola de Enfermagem de Ribeirão Preto / Universidade de São Paulo Av. Bandeirantes, 3900, 14040-902 Ribeirão Preto SP Brazil, Tel.: +55 (16) 3315-3451 / 3315-4407 - Ribeirão Preto - SP - Brazil
E-mail: rlae@eerp.usp.br

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[1] Corresponding Author: Geraldo Magela Salomé Universidade do Vale do Sapucaí Faculdade de Ciências Médicas Dr. José Antônio Garcia Coutinho Av. Francisco de Paula Quintanilha Ribeiro, 280 Bairro: Jabaquara CEP: 04330-020, São Paulo, SP, Brasil E-mail: gsalome@infinitetrans.com

Variables	N*	% ^†	Valid % ^†	Accumulated % ^†
Academic education
Nursing	14	58.4	58.4	58.4
Physiotherapy	8	33.3	33.3	91.7
Medicine	2	8.3	8.3	100
Total	24	100	100
p-value ^‡		0.023 ^§
Period of time after undergraduate completion (years)
4 - 9	5	20.8	20.8	20.8
10 - 19	6	25.0	25.0	45.8
20 - 29	7	29.2	29.2	75.0
30 - 44	6	25.0	25.0	100
Total	24	100	100
p-value ^‡		0.079 ^§
Graduate degree
Yes	23	95.8	95.8	95.8
No	1	4.2	4.2	100
Total	24	100	100
p value ^‡		0.003 ^§

Questions	Poor		Average		Good		Excellent		p value ^‡
Questions	n*	% ^†	n*	% ^†	n ^†	% ^§	n ^†	%*	p value ^‡
Graphic presentation	0	0	1	4.2	5	20.8	18	75.0	0.001 ^§
Ease of reading	0	0	4	16.7	10	41.7	10	41.7	0.856 ^§
Sequence of the algorithm	0	0	1	4.2	3	12.5	20	83.3	0.001 ^§
Description
Wound measurement technique	0	0	2	8.3	5	20.8	17	70.8	0.001 ^§
Exudate type	0	0	4	16.7	3	12.5	17	70.8	0.001 ^§
Assessment of exudate amount	0	0	1	4.2	3	12.5	20	83.3	0.001 ^§
Signs of infection	1	4.2	1	4.2	3	12.5	19	79.2	0.001 ^§
Scrubbing cleaning technique for devitalized tissue	2	8.3	0	0	3	12.5	19	79.2	0.001 ^§
“Jet” cleaning technique for granulation fabric	1	4.2	1	4.2	5	20.8	17	70.8	0.001 ^§
Indication of ABI ^\|\|	0	0	2	8.3	5	20.8	17	70.8	0.001 ^§
Indication of cleaning technique for epithelial wound tissue	1	4.2	1	4.2	3	12.5	19	79.2	0.001 ^§
Therapeutic action on acute wound with devitalized tissue	1	4.2	3	12.5	5	20.8	15	62.5	0.007 ^§
Laser therapy parameters for acute wound with granulation tissue	1	4.2	1	4.2	7	29.2	15	62.5	0.007 ^§
Laser therapy parameters for acute wound with epithelial tissue	1	4.2	2	8.3	5	20.8	16	66.7	0.007 ^§
Therapeutic action on chronic wound with devitalized tissue	1	4.2	1	4.2	6	25.0	16	66.7	0.007 ^§
Laser therapy parameters for chronic wound with granulation tissue	1	4.2	2	8.3	5	20.8	16	66.7	0.007 ^§
Laser therapy parameters for chronic wound with epithelial tissue	1	4.2	2	8.3	3	12.5	18	75.0	0.001 ^§

Questions	Mean if item excluded	Variance if item excluded	Corrected item-item correlations	Cronbach’s alpha if item excluded
Graphic presentation	67.63	121.549	0.770	0.958*
Ease of reading	68.08	121.210	0.581	0.960*
Sequence of the algorithm	67.54	125.042	0.517	0.961*
Description
Wound measurement technique	67.71	120.824	0.699	0.959*
Exudate type	67.79	116.607	0.831	0.957*
Assessment of exudate amount	67.54	121.911	0.802	0.958*
Signs of infection	67.67	124.145	0.381	0.963*
Scrubbing cleaning technique for devitalized tissue	67.71	116.911	0.714	0.959*
“Jet” cleaning technique for granulation fabric	67.75	118.804	0.697	0.959*
Indication of ABI ^\|\|	67.71	118.737	0.853	0.957*
Indication of cleaning technique for wound epithelial tissue	67.67	119.014	0.698	0.959*
Therapeutic action on acute wound with devitalized tissue	67.92	115.819	0.770	0.958*
Laser therapy parameters for acute wound with granulation tissue	67.83	118.145	0.733	0.958*
Laser therapy parameters for acute wound with epithelial tissue	67.83	115.101	0.860	0.957*