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
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
Background: Chronic wounds fail to progress through a normal sequence of repair. This study aimed to evaluate the chronic wound patient journey among healthcare professionals (HCPs) and patients in Indian settings.
Methods: A survey questionnaire was framed, including patient burden, initial diagnosis and treatment preference, referral pathway, challenges, and unmet needs of HCPs and patients.
Results: A total of 100 HCPs and 30 patients participated in the survey. The primary challenges faced by the patients include high treatment costs and accessibility to healthcare centres while HCPs reported high treatment cost and lack of awareness as challenges. Affordable treatment options and lack of awareness were cited as prime unmet needs by both HCPs and patients.
Conclusion: The use of adapted products and early initiation of treatment can aid in faster wound healing and can be cost-effective.
Authors:
Arun Bal, Sanjay Vaidya, Rajiv Parakh, Vivekanand, Pavan Belehalli, Madhu Periasamy, Jessy Thomas, Bharat Kotru, Beulah Priyadharshini D R, Venugopal K and Pratik Bhide
Arun Bal is Consultant Diabetic Foot Surgeon, S L Raheja Hospital, Mumbai, India;
Sanjay Vaidya is Consultant Plastic Surgeon, S L Raheja Hospital, Mumbai, India;
Rajiv Parakh is Consultant– Peripheral Vascular and Endovascular Surgery, Medanta Hospital, Gurugram, India;
Vivekanand is Consultant Vascular Surgeon, BMJ Hospital, Bangalore, India;
Pavan Belehalli is Orthopaedic Surgeon, KIER, Bangalore, India;
Madhu Periasamy is Consultant Plastic Surgeon, Ganga Hospital, Coimbatore, India;
Jessy Thomas is Surgeon – Podiatry, Hiranandani Hospital, Mumbai, India;
Bharat Kotru is Podiatrist and Wound Care Specialist, Max Hospital and Amandeep Hospital, Amritsar, India;
Beulah Priyadharshini D R is Medical Affairs Manager – India, Urgo Medical;
Venugopal K is Medical Affairs & Training Specialist – India, Urgo Medical;
Pratik Bhide is Managing Director, India, Urgo Medical
Providencia rettgeri is a Gram-negative bacillus that is most usually seen in urinary tract infections. Skin and soft tissue infections with P rettgeri are rare and there few case reports described in the literature. A 43-year old woman presented to the emergency department with a leg ulcer of 3 months duration. Microbiological results isolated P rettgeri and Pseudomonas aeruginosa. She underwent surgical debridement and split-thickness skin grafting alongside IV antibiotic therapy and dressing care, with complete resolution of the wound 3 months after admission. The differential diagnosis of leg ulcers is wide and must include infection and venous insufficiency. Although venous ulcers are common, typically they are not responsible for rapid evolving ulcers that destroy tissues below the muscular fascia. In this case report, the authors hypothesise that P rettgeri had a major role in the severity of the ulcer in an otherwise healthy woman. A greater understanding of how P rettgeri affects wound pathophysiology is needed in order to distinguish between colonisation versus infection and discriminate bacterial synergy, as well as having better treatment guidelines.
Miguel Veríssimo, Diogo Guimarães, Diogo Casal, Sara Carvalho, Miguel Matias, Raquel Barbosa and Joaquim Bexiga
Miguel Veríssimo is Resident. Diogo Guimarães is Resident. Diogo Casal is Attending Physician. Sara Carvalho is Attending Physician. Miguel Matias is Resident. Raquel Barbosa is Resident. Joaquim Bexiga is Attending Physician. All at Plastic Surgery Department, Centro Hospitalar Universitário Lisboa Central, Lisbon, Portugal.
What makes a good formulary?
The importance of evidencebased practice
Considering cost
Change management
Addressing challenges and
measuring success
BEST PRACTICE STATEMENT: DEVELOPMENT OF A WOUND CARE FORMULARY USING CLINICAL EVIDENCE AND ENSURING EFFECTIVE CHANGE MANAGEMENT
PUBLISHED BY:
Wounds UK
A division of Omniamed Communications, 108 Cannon Street London EC4N 6EU, UK www.wounds-uk.com
This document has been developed by Wounds UK and is supported by an unrestricted educational grant from Urgo Medical.
This publication was coordinated by Wounds UK with the Expert Working Group and Review Panel. The views presented in this document are the work of the authors and do not necessarily
How to cite this document:
Wounds UK (2023) Best Practice Statement: Development of a wound care formulary using clinical evidence and ensuring effective change management. Wounds UK, London. Available to download from: www.woundsuk.com reflect the views of Urgo Medical.
EXPERT WORKING GROUP:
Jacqui Fletcher OBE (Chair), Independent Nurse Consultant
Andrew Sharpe, Advanced Podiatrist, Wound Care, Salford Care Organisation, Salford
Caroline Dowsett, Clinical Nurse Specialist, Tissue Viability Services, East London NHS Foundation Trust
David Wylie, Managing Director, DAWN Health & Care Consultancy UK Ltd; Honorary Fellow, Glasgow Caledonian University, Glasgow
Dawn Douglas, Community Matron, Northumbria Healthcare NHS Foundation Trust
Graham Bowen, Principal Podiatrist, Solent NHS Trust
Hollie Robinson, Tissue Viability Service Lead, South Warwickshire NHS Foundation Trust
Joy Tickle, Tissue Viability Nurse Consultant, Isle of Wight NHS Trust
Kelly Phillips, Skin Integrity Lead Nurse, Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust
Leanne Atkin, Vascular Nurse Consultant, Mid Yorkshire NHS Trust; Research Fellow, University of Huddersfield
Michelle Goodeve, Senior Diabetes Specialist Podiatrist, Provide Community Interest Company
Nina Murphy, Operational Lead for Tissue Viability, North East London NHS Foundation Trust
Rebecca Elwell, Trustee, British Lymphology Society; Macmillan Lymphoedema ANP and Team Leader, University Hospitals of North Midlands NHS Trust
Sian Fumarola, Head of Clinical Procurement, North Midlands and Black Country NHS Procurement Group
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
扫一扫了解详情:
任何关于疾病的建议都不能替代执业医师的面对面诊断。所有门诊时间仅供参考,最终以医院当日公布为准。
网友、医生言论仅代表其个人观点,不代表本站同意其说法,请谨慎参阅,本站不承担由此引起的法律责任。