Practical effect of standardized management path for inpatients with chronic and difficult-to-heal wounds_West China Medical Journal

Authors：

GAO Li ,  HU Linjuan , CHEN Li , LI Huidan , ZHAO Hua

Wound Repair Center of Burn and Plastic Surgery Department, People’s Hospital of Deyang City, Deyang, Sichuan 618000, P. R. China;

Corresponding?author：

HU Linjuan, Email: 1679437661@qq.com

Keywords：

Chronic and difficult-to-heal wounds; Repair; Specification; Management

DOI：

10.7507/1002-0179.202103193

Video：

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Objective To explore the practical effect of standardized management path for inpatients with chronic and difficult-to-heal wounds.Methods The inpatients with chronic and difficult-to-heal wounds in People’s Hospital of Deyang City from July 2015 to June 2019 were collected. According to the random number table, the patients were divided into control group and intervention group. The control group were given routine management and the intervention group were given standardized management. Skin symptoms, Visual Analogue Scale (VAS), wound healing time, length of hospital stay, efficacy, complications, satisfaction and scar hyperplasia were recorded and compared.Results A total of 605 patients were included. There were 314 cases in the control group and 291 cases in the intervention group. Before treatment, there was no significant difference in skin symptom score or VAS score between the two groups (P>0.05); after treatment, the skin symptom scores and VAS scores of the two groups decreased (P<0.05), and the scores in the intervention group were lower than those in the control group (P<0.05). The wound healing time [(24.21±1.42) vs. (18.59±1.63) d; t=45.301, P<0.001] and length of hospital stay [(26.97±1.54) vs. (20.03±1.42) d; t=57.492, P<0.001] in the intervention group were shorter than those in the control group. All patients were followed up. The total effective rate (χ²=3.911, P=0.048) and satisfaction (χ²=4.340, P=0.037) of the intervention group were higher than those of the control group. The degree of scar hyperplasia (Z=4.913, P<0.001) and the incidence of complications (P=0.039) of the intervention group were also lower than those of the control group.Conclusions The standardized management of hospitalized patients can significantly shorten the chronic and difficult-to-heal wounds healing time, reduce the occurrence of complications, improve the patient’s satisfaction and prognosis. It is worthy of clinical application.

Citation： GAO Li, HU Linjuan, CHEN Li, LI Huidan, ZHAO Hua. Practical effect of standardized management path for inpatients with chronic and difficult-to-heal wounds. West China Medical Journal, 2021, 36(7): 907-912. doi: 10.7507/1002-0179.202103193 Copy

1.	de Albuquerque KC, da Veiga AD, Silva JV, et al. Brazilian Amazon traditional medicine and the treatment of difficult to heal leishmaniasis wounds with Copaifera. Evid Based Complement Alternat Med, 2017, 2017: 8350320.
2.	Black KD, Cico SJ, Caglar D. Wound management. Pediatr Rev, 2015, 36(5): 207-215.
3.	付小兵. 建設具有中國特色的網絡化創燒傷救治體系以提高救治成功率的理論與實踐. 中華損傷與修復雜志(電子版), 2019, 14(1): 4-8.
4.	Listewnik MJ, Sielicki P, Mokrzycki K, et al. The use of vacuum-assisted closure in purulent complications and difficult-to-heal wounds in cardiac surgery. Adv Clin Exp Med, 2015, 24(4): 643-650.
5.	Wang X, Shu X, Li Z, et al. Comparison of two kinds of skin imaging analysis software: VISIA? from Canfield and IPP? from media cybernetics. Skin Res Technol, 2018, 24(3): 379-385.
6.	Duncan JAL, Bond JS, Mason T, et al. Visual analogue scale scoring and ranking: a suitable and sensitive method for assessing scar quality?. Plast Reconstr Surg, 2006, 118(4): 909-918.
7.	張偉, 張俊峰, 王覓, 等. 體表慢性難愈合創面患者下肢深靜脈血栓形成的發生情況及影響因素. 中華醫學雜志, 2020, 100(4): 291-294.
8.	Cocjin HGB, Jingco JKP, Tumaneng FDC, et al. Wound-healing following negative-pressure wound therapy with use of a locally developed aquavac system as compared with the vacuum-assisted closure (VAC) system. J Bone Joint Surg Am, 2019, 101(22): 1990-1998.
9.	張振宇, 劉睿奇, 王茹, 等. 三維立體力學平衡理念在全耳再造軟骨支架構建中的應用. 中國修復重建外科雜志, 2019, 33(3): 332-336.
10.	Sorg H, Tilkorn DJ, Hager S, et al. Skin wound healing: an update on the current knowledge and concepts. Eur Surg Res, 2017, 58(1/2): 81-94.
11.	Han G, Ceilley R. Chronic wound healing: a review of current management and treatments. Adv Ther, 2017, 34(3): 599-610.
12.	楊紅明. 難愈性創面治療進展與面臨的挑戰. 中華燒傷雜志, 2016, 32(4): 193-195.
13.	Kathawala MH, Ng WL, Liu D, et al. Healing of chronic wounds: an update of recent developments and future possibilities. Tissue Eng Part B Rev, 2019, 25(5): 429-444.
14.	Wang PH, Huang BS, Horng HC, et al. Wound healing. J Chin Med Assoc, 2018, 81(2): 94-101.
15.	Chen YT, Chang CC, Shen JH, et al. Demonstrating a conceptual framework to provide efficient wound management service for a wound care center in a tertiary hospital. Medicine (Baltimore), 2015, 94(44): e1962.
16.	Childs DR, Murthy AS. Overview of wound healing and management. Surg Clin North Am, 2017, 97(1): 189-207.

1. de Albuquerque KC, da Veiga AD, Silva JV, et al. Brazilian Amazon traditional medicine and the treatment of difficult to heal leishmaniasis wounds with Copaifera. Evid Based Complement Alternat Med, 2017, 2017: 8350320.
2. Black KD, Cico SJ, Caglar D. Wound management. Pediatr Rev, 2015, 36(5): 207-215.
3. 付小兵. 建設具有中國特色的網絡化創燒傷救治體系以提高救治成功率的理論與實踐. 中華損傷與修復雜志(電子版), 2019, 14(1): 4-8.
4. Listewnik MJ, Sielicki P, Mokrzycki K, et al. The use of vacuum-assisted closure in purulent complications and difficult-to-heal wounds in cardiac surgery. Adv Clin Exp Med, 2015, 24(4): 643-650.
5. Wang X, Shu X, Li Z, et al. Comparison of two kinds of skin imaging analysis software: VISIA? from Canfield and IPP? from media cybernetics. Skin Res Technol, 2018, 24(3): 379-385.
6. Duncan JAL, Bond JS, Mason T, et al. Visual analogue scale scoring and ranking: a suitable and sensitive method for assessing scar quality?. Plast Reconstr Surg, 2006, 118(4): 909-918.
7. 張偉, 張俊峰, 王覓, 等. 體表慢性難愈合創面患者下肢深靜脈血栓形成的發生情況及影響因素. 中華醫學雜志, 2020, 100(4): 291-294.
8. Cocjin HGB, Jingco JKP, Tumaneng FDC, et al. Wound-healing following negative-pressure wound therapy with use of a locally developed aquavac system as compared with the vacuum-assisted closure (VAC) system. J Bone Joint Surg Am, 2019, 101(22): 1990-1998.
9. 張振宇, 劉睿奇, 王茹, 等. 三維立體力學平衡理念在全耳再造軟骨支架構建中的應用. 中國修復重建外科雜志, 2019, 33(3): 332-336.
10. Sorg H, Tilkorn DJ, Hager S, et al. Skin wound healing: an update on the current knowledge and concepts. Eur Surg Res, 2017, 58(1/2): 81-94.
11. Han G, Ceilley R. Chronic wound healing: a review of current management and treatments. Adv Ther, 2017, 34(3): 599-610.
12. 楊紅明. 難愈性創面治療進展與面臨的挑戰. 中華燒傷雜志, 2016, 32(4): 193-195.
13. Kathawala MH, Ng WL, Liu D, et al. Healing of chronic wounds: an update of recent developments and future possibilities. Tissue Eng Part B Rev, 2019, 25(5): 429-444.
14. Wang PH, Huang BS, Horng HC, et al. Wound healing. J Chin Med Assoc, 2018, 81(2): 94-101.
15. Chen YT, Chang CC, Shen JH, et al. Demonstrating a conceptual framework to provide efficient wound management service for a wound care center in a tertiary hospital. Medicine (Baltimore), 2015, 94(44): e1962.
16. Childs DR, Murthy AS. Overview of wound healing and management. Surg Clin North Am, 2017, 97(1): 189-207.

West China Medical Journal

Practical effect of standardized management path for inpatients with chronic and difficult-to-heal wounds

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