大湾区慢性创面医护康标准化体系建设联盟,《中国科技论文》体表外科卷编辑委员会,黄广涛1,吴 军1,郇京宁1,2
(1.深圳大学第一附属医院(深圳市第二人民医院)烧伤整形科,广东深圳518000;2.上海交通大学医学院附属瑞金医院烧伤整形与创面修复科,上海200011)
摘要:负压封闭引流技术(negative pressure wound therapy, NPWT)自2017年国内首部烧伤外科应用专家共识发布以来,其技术类型与临床应用范围均取得了显著拓展。特别是在促进各类急慢性创面愈合及预防外科手术部位感染方面,已累积了大量高质量循证证据。为整合国内外最新研究成果与临床实践经验,规范操作标准,提升治疗水平,国内创面修复相关多学科领域的专家共同撰写了本更新版共识。本共识汇聚了国内多位在创面相关的多学科领域的专家,结合国内外最新研究成果,遵循严谨的循证医学原则,采用系统综述方法,聚焦于NPWT的技术分类、适应症、参数优化及并发症处理等核心议题。工作小组系统检索了PubMed、Web of Science、IEEE Xplore及中国知网等数据库中2015—2025年相关文献,共获得791篇。经去重、筛选,并根据纳入标准(临床研究、随机对照试验、meta分析及相关共识等)最终纳入210篇文献进行证据综合与评价。本共识旨在为创面修复相关学科的临床医生提供基于最新证据、统一且可操作的治疗方案与技术规范。共识内容充分结合了我国临床实践的现状与需求,以期推动NPWT在国内的合理、规范及高效应用,最终惠及广大患者。
关键词:负压封闭引流技术;手术部位感染;创面修复;手术切口并发症
Yesica Y. Quiroz 1 , Enver Moncada 2 , Erika Llorens 3 , Ivan Schwartzmann 4 , Jorge Caffarati 5 , Anna Bujons *
Summary
Introduction
Paratesticular sarcoma is an aggressive malignant tumor of mesenchymal origin. The rhabdo-myosarcoma is the most common among children. Rhabdomyosarcoma treatment consists of surgery, chemotherapy and radiotherapy. Prognosic depends on local recurrence and distant metastasis.
Material and methods
We present the case of a 16-year-old male, who in April 2016 underwent right radical orchiectomy surgery by testicular mass rapidly evolving, with pathological results indicating a paratesticular rhabdomyosarcoma. The extension study showed a precaval adenopathy suggestive of lymph node metastasis, therefore it was a high-grade rhabdomyosarcoma. There was an appropriate response after chemotherapy (Protocol EpSSG RMS2005) and we decided to perform a robotic.
Results
We performed a transperitoneal approach with 8 mm trocar and 12 mm optica trocar. We accessed the retroperitoneal space through a latero-colic incision. Then we performed a craniocaudal lymph node dissection until the aortic bifurcation. The surgical time was 240 min with a blood loss of 200 ml. There were no complications. The patient was discharged on the fourth day after surgery. Pathology showed metastasis of rhabdomyosarcoma without capsular rupture. After two months, we placed the left testicle into inguinal canal prior to radiotherapy.
Conclusions
Robotic lymph node metastasis lymphadenectomy from paratesticular sarcomas is a feasible treatment with the advantage of minimally invasive surgery and acceptable morbidity.
Aim: The objective of this study is to evaluate the safety and efficacy of a negative pressure wound therapy (NPWT) device in trauma and other complex wounds.
Methods: The present clinical study is a prospective, interventional study conducted at a tertiary care center. NPWT was applied and the Bates-Jensen Score was calculated to assess the improvement in
wound healing outcomes.
Results: Twenty-two patients were assessed. The outcomes demonstrated that NPWT treatment reduced Bates-Jensen score when compared with the baseline score.
Conclusion: This indicates that NPWT therapy facilitates wound healing by increasing granulation tissue formation and lowering wound exudate levels.
Key words:
■Bates-Jensen Score,
■Negative pressure wound therapy
■Trauma Wounds
■Wound Exudate
■Wound Healing
■Wound management
Sushma Sagar is Professor, All India Institute of Medical Science, New Delhi, India;
Parvez Mohi Ud Din Dar is Senior Resident, All India Institute of Medical Sciences New Delhi;
Subodh Kumar is Professor, All India Institute of Medical Sciences New Delhi;
Amit Gupta is Professor, All India Institute of Medical Sciences New Delhi
This article first appeared in our sister publication Wounds Asia in volume 5 issue 2. Citation: Improved Bates-Jensen score following negative pressure wound therapy on wounds of various aetiologies: an experience from a tertiary care centre. Wounds Asia 5(3): 15–21
Nazli Parast, Pamela Walsh
This article presents a quality improvement study focused on developing a health literacy assessment tool for certified diabetes educators in Canada to use during virtual consultations with people diagnosed with type 2 diabetes. The study aims to improve healthcare professionals’ understanding of their patients’ health literacy levels in order to provide tailored education and support for diabetes self-management. It explores the prevalence and management of diabetes, the role of health literacy and education in diabetes management, and the significance of the study. The research questions address the effectiveness and practicality of existing health literacy tools in virtual consultations, the potential for improvement or development of a new tool, and the implications for patient-centred care in diabetes education. The article emphasises the importance of assessing health literacy in virtual consultations to ensure effective diabetes management and better outcomes for individuals living with the condition.
Citation: Parast N, Walsh P (2023) Empowering diabetes selfmanagement: A qualitative study on developing and evaluating health literacy tools for virtual consultations with certified diabetes educators. Journal of Diabetes Nursing 27: JDN311
Article points
1. A study was conducted to develop a tool to assess during virtual consultations the health literacy of people with type 2 diabetes.
2. For healthcare professionals to provide effective diabetes education, it is essential that an understanding of an individual’s health literacy is gained.
3. Through a quality improvement approach, participating certified diabetes educators helped to develop a new tool with the potential to help ensure effective self-management and improved outcomes.
Key words
- Certified diabetes educators
- Health literacy tools
- Type 2 diabetes
Authors
Nazli Parast, Advanced Practice
Nurse and Diabetes
Nurse Educator, and Pamela
Walsh, Associate Professor,
Athabasca University, Athabasca,
Alberta, Canada.
A pre-specified secondary analysis of the DELIVER randomised controlled trial in 5788 people with heart failure with mildly reduced or preserved ejection fraction, with or without type 2 diabetes, explored the implications of early eGFR changes after initiation of dapagliflozin on later cardiovascular and renal risk. As expected, from baseline to 1 month, eGFR declines of >10% were more common in those actively treated with dapagliflozin than in those treated with placebo, occurring in 40% versus 25%. In placebo recipients, experiencing an initial eGFR reduction of >10% was associated with a higher risk of major adverse cardiovascular events. However, in those treated with dapagliflozin, although an initial eGFR reduction of >10% was common, this was not associated with adverse cardiovascular or renal outcomes compared to those treated with dapagliflozin who experienced smaller initial reductions in eGFR. The authors concluded that these findings reinforce the advice, based on earlier studies in those at high risk of cardiorenal disease, that SGLT2 inhibitors need not usually be discontinued or interrupted in response to an initial eGFR reduction. Other studies and editorials have concluded that routine monitoring of renal function is not required after initiating SGLT2 inhibitors unless volume depletion is considered a risk.
Pam Brown
GP in Swansea
Citation: Brown P (2023) Diabetes
Distilled: DELIVERing reassurance that early eGFR reductions with SGLT2 inhibitors should not prompt drug discontinuation. Diabetes & Primary Care 25: 205–7
Deborah Christie
Professor of Paediatric and Adolescent Psychology, University College London Hospitals and Dartford and Gravesham NHS Trusts
Citation: Christie D (2023) Q&A: Breaking the cycle – Empowering healthcare professionals to overcome stigma in diabetes care. Diabetes & Primary Care 25: 183–6 Q&A
Article disclosure: This article describes research commissioned by Abbott, and Professor Christie was paid a fee by Abbott to contribute to this article. The views expressed are those of the author and not necessarily those of Abbott. The article was commissioned by the Editorial Board as a topic of interest. The journal has received no funding, and all peer review and editorial decisions have been made independently and according to the journal’s usual procedures.
Citation: Christie D (2023) Q&A: Breaking the cycle – Empowering healthcare professionals to overcome stigma in diabetes care. Diabetes & Primary Care 25: 183–6
伤口世界平台生态圈,以“关爱人间所有伤口患者”为愿景,连接、整合和拓展线上和线下的管理慢性伤口的资源,倡导远程、就近和居家管理慢性伤口,解决伤口专家的碎片化时间的价值创造、诊疗经验的裂变复制、和患者的就近、居家和低成本管理慢性伤口的问题。
2019广东省医疗行业协会伤口管理分会年会
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