| ObjectiveTo retrospective analysis of the clinical characteristics and changing trends of chronic wound patients admitted to the General Hospital of Southern Theater Command,PLA provided a theoretical basis for the establishment of wound repair specialists(or centers)and the formulation of chronic wound control strategies.MethodsIn this survey,the General Hospital of Southern Theater Command,PLA was selected as the research center to collect the medical records of the patients hospitalized for chronic wounds from January 1,2007 to December 31,2018.Skin tissue defect does not heal after 1 month of treatment and no tendency to heal is the criterion),collect the patient's gender,occupation,age,etiology,past hi story,treatment method,bacterial etiology,treatment outcome,department Distribution,healing time,hospitalization time and hospitalization costs and other health economics related content.SPSS 22.0 was used to compare chi-square test,Fisher's exact test and Kruskal-Wallis H test among different groups.Results(1)A total of 530,654 inpatients were admitted to the hospital,of which 1,753 were chronic wounds(0.33%).The proportion of inpatients with chronic wounds in the hospital during the past 12 years was 0.24%(106/44230)?0.42%(137/32528);1135 males(64.7%)and 618 females(35.3%);and the elderly were frequent.(2)The main reasons for the formation of chronic wound patients in this hospital are diabetes(30.7%),iatrogenic wounds(24.8%),and trauma(16.3%);most of the chronic wounds are single wounds,and the most common location is the lower extremities And torso.Gram-negative bacteria are the main culture of chronic wound secretions,and Staphylococcus aureus is the most common single strain(19.21%).(3)The statistics of this study showed that the causes of chronic wounds in patients of different ages(?2=28.12,P<0.05)and different genders(?2=40.70,P<0.05)were statistically different..Male patients had a higher proportion of traumatic wounds 224(19.7%)than female patients,and there was a statistical difference(?2=27.59,P<0.05);37.7%of female patients had diabetic ulcers,and male diabetic wounds accounted for 27%,a statistical difference(?2=6.43,P<0.05).Diabetic wounds are mainly distributed in the age of 61?80;iatrogenic wounds are more common in the age of 0?20;traumatic wounds are more common in the age of 21?40;compression wounds are more common in the elderly and increase with age.(4)The average length of hospitalization of chronic wounds in multiple departments was longer than that of departments.The department with the highest healing rate of chronic wounds was the spine department(59.1%),followed by the orthopaedic joint department(43.1%).The cost of hospitalization(?2=47.39,P<0.05)and the length of stay were statistically different(?2=107.39,P<0.05).The ICU department has the highest hospitalization cost,reaching104556.7yuan,and the lowest cost for general surgery hospitalization is 13475.7 yuan;the average length of hospitalization for the cadre department is 68.5 days,and the number of days for cardiac surgery is 16 days less.(5)Statistics showed that the recovery rate(?2=141.24,P<0.05)and the recovery time(?2=28.11,P<0.05)were statistically different.The highest healing rate was caused by 201 iatrogenic wounds(46.3%),followed by traumatic wounds 108 Cases(37.8%),the worst healing rate was diabetic wounds,only 13.5%.Compression wounds require the longest healing time(38.5days),followed by traumatic wounds(31days),and venous wounds are relatively short(19days).The rate of complete wound healing at discharge was only 29.3%.The healing rate of chronic wounds was different between different treatments,and there was a statistical difference(?2=129.38,P<0.05).The healing rate of conservative treatment was higher than that of other treatments.Poor in which the treatment of muscle flap,skin flap,and composite tissue flap is better,and the wound healing rate is higher.(6)The average length of hospitalization for this patient population was 25 days,and the average hospitalization cost was 24,335yuan.59%(1034 cases)of chronic wound patients were reimbursed for different forms of medical insurance,with 41%of patients at their own expense;of which,medicine accounted for medical treatment.The cost is 45.4%.ConclusionThe chronic wound patients in this hospital are more common in manual workers and middle-aged and elderly people,and the length of hospitalization is long,which brings serious economic burden to patients and society.It is necessary to establish a wound repair specialty to regulate the management and treatment of such wounds,implement specialized treatments,and improve the cure rate.And develop a chronic wound knowledge publicity program to improve prevention and control awareness. |
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