Epidemiology Of Chronic Cutaneous Wounds In China

Objective:Chronic cutaneous wounds represent a major health care burden in China. However, limited information exists regarding the epidemiologic changes associated with recent social and economic development.Methods:We designed a cross-sectional survey in 2,513 patients who underwent treatment of chronic cutaneous wounds from a nationally representative sample in 17 hospitals between 2007 and 2008.Results:Results revealed the prevalence of chronic cutaneous wounds among hospitalized patients was 1.7%o. Patient ages ranged from 18 days to 96 years (median,58 years). The highest ratios were among 40-60 and 60-80-year-old patients (31% and 38%, respectively). The leading causes of chronic cutaneous wounds were diabetes (31.3% men,35.3% women) and trauma (26.4% men, 19.2% women). Manual workers (38.5% men,29.3% women) and retirees (27.9% men,23.5% women) accounted for over half the chronic cutaneous wound patients. Most patients (62%) had one ulcer, and often lying on lower extremitites (90.4%). Only 1/3 patients had results of bacterial cultivation. Bacterial categories included Gram positive bacterium, Gram-negative rod, Gram positive coccus, Gram-negative coccus, and fungi. There were 65 kinds of pathogenic microorganism in the results. Staphylococcus aureus was the most important pathogenic bacterium. Aeruginosus bacillus was the most Gram-negative rod, and the second important pathogenic bacterium. Regarding treatments, only 22.4% were treated with modern dressings or other novel technologies, such as NPWT and HBOT, and more patients received antibiotics (77.8%). Treatment was paid for by the patients in 42.3% of cases, by social medical insurance in 25.0%, by commercial medical insurance in 4.8%, while 27.9% received free medical care. Approximately half the patients' wounds were completely healed at discharge (1,345/2,513). In all diabetic foot patients,95% were Wagner 2 to 4 grades.Conclusion:In conclusion, camparing the study completed ten years ago, diabetes has recently become the leading cause of chronic cutaneous wounds in China. The large population and considerable financial burden mean that serious attention should be paid to the early detection, prevention and diagnosis of chronic cutaneous wounds, and suggest that an overall health insurance system should be established, especially for the elderly.