Investigation And Analysis Of Clinical Characteristics Of Inpatients With Dermal Chronic Ulcer In Recent Five Years

Objective: Through the retrospective investigation and analysis of hospitalizedpatients with dermal chronic ulcer, the related factors of the crowd and the clinicalfeatures for the treatment measures and effect of these patients，this research is aimedat improving the common people and medical workers’ understanding and awarenessof dermal chronic ulcer so that it can provide the clinical information about reducingthe incidence of such wounds and improving the effect of treatment, and provide thelocal health departments with theoretical basis of prevention to formulate measures.Method: Collect the538patients who were admitted to Department of Burn andPlastic Surgery in Chenzhou First People’s Hospital from January1,2009to2013December31and whose skin and soft tissue defects, bone exposed wounds which didnot heal after being treatment more than1month. Look up their medical records,record relevant information, and take the patients’ gender, age, occupation, causes,location, urban and rural distribution, the annual number of hospitalizations, visits,treatment methods and the average length of stay and other related indicators asretrospective statistical analysis, combined with descriptive analysis of charts andtables. On the part of the data using SPSS13.0statistical software line chi-square (x2)test and analysis of variance (F), with a=0.05level for the test.Results:1. This study collected538cases of inpatients with dermal chronic ulcer，including367male cases (68.2%),171female cases (31.8%), male: female was2.14:1; the youngest was6months years old and the oldest was91years old.①. Themaximum peak age range of61~70years old,105cases (19.5%), followed by31~40years old,96cases (17.8%),51~60years old,77cases(14.3%),71~80years old,69cases (12.8%),41~50years old,61cases (11.3%),21~30years old,56cases(10.4%),11~20years old,31cases (5.8%),10years or less29cases (5.4%)、81yearsor higher14cases (2.7%);②. Therural patients were436cases (81.1%), the town 102patients (18.9%), rural: towns4.27:1;③.Manual labor accounts for the vastmajority of patients with a total of287cases (53.3%), followed by a total of140cases(26.0%) of retirees, mental work,86cases (16.0%) and other25cases (4.7%);④. Pressure is the first factor of theulcer with a total of252cases (46.8%), thesecond one was respectively109diabetic patients (20.2%), traumatic55cases(10.2%), peripheral vascular34cases (6.4%), other reasons for20cases (3.8%),radioactive15cases (2.8%), loss of nerve after8cases (1.5%);⑤. In recent fiveyears, the number of cases was gradually increased from85cases (15.8%) in2009,96cases (17.8%) in2010,107cases (19.9%) in2011,119cases (22.1%) in2012, to131cases (24.4%) in2013.2. This research shows the characteristics of the538cases of inpatients with dermalchronic ulcer:①. The ulcer mostly distribute in the lower limbs, a total of362cases(67.3%), followed by sacral back end, a total of93cases (17.3%), chest perineumwere45cases (8.3%), upper limbs and head, face and neck distribution of28cases(5.2%),10cases (1.9%);②.Most patients, after the formation of the ulcer, go to seethe rural doctors and besmear outside herbs and folk ointment. If they aren’t cured,they go to the county-level hospitals for some days, then they are transferred to ourhospital, a total of397cases (73.8%);③.Our first choice in the treatment of chroniculcer after admission for area damage small and satisfactory results of autologous freeflap to repair, a total of367cases (68.2%), ortho flap and axial flap, a total of123cases (22.9%), free flap, a total of19cases (3.5%),538patients in497cases werecured（,65cases of two or more times a surgery),29case（s5.4%） with discharge linedue to the economy of conservative treatment.3. This study also found that the comparison between the differences of the inpatientswith dermal chronic ulcer caused by different reasons in men and women and thenumber of cases distribution has obvious statistical significance difference (x2=32.14,p <0.05); The men and women of all ages inpatients with dermal chronic ulcer casesdistribution are compared, differences have statistical significance (x2=19.72, p <0.05); The different occupational of inpatients with dermal chronic ulcer in men andwomen are compared, the number of cases distribution difference was statistically significant (x2=24.12, p <0.05). Patients with dermal chronic ulcer stress caused bythe average such confinement longest [(48.65±26.31)d], and patients with chroniculcer caused by different reasons, comparing the average such confinement significantsexual differences (F=25.88, p <0.01).Conclusion:1.From January2009to December2013, the population characteristicsof inpatients with chronic ulcer in the First People’s Hospital of Chenzhou City:mainly male, mostly in the rural patients, manual laborers mostly frequent, see mostlyaged in61~70, the chronic ulcer was mostly caused by pressure and diabetes, partsin lower limb, for the most frequent, and the incidence of dermal chronic ulcerincreased year by year at the rate of10%.2. The patient should see a doctor withclinical experience in the large hospital as soon as possible after the formation of theulcer and avoid to applying herbs and folk prescription; For the ulcer repair, thetreatment method should be simple as much as possible not to fan the principles ofplastic surgery, with minimal donor site damage as much as possible following theprinciples of plastic surgery, with minimal donor site damage cost, for best results.3.The different causes, different ages, different careers of patients with dermal chroniculcer in different gender distribution also differ, and the ulcers caused by differentreasons are not the same as the average length of stay.4. Popularizing and raisingpeople, especially at the grass-roots level and civilian battalion hospital medicalworkers’ understanding of chronic ulcer, grasping the positive and effective therapy totreat, and fully understanding the hazards, is the best shortcut to reduce the incidenceof such wounds, It is suggested that, for the local related department of health, it isnecessary to strengthen the propaganda and formulate prevention measures.