| Purpose: A retrospective review of patients with chronic wounds in our hospital in 2018 was conducted through analysis of etiology,disease status,wound evaluations and treatmentrelated information,to study the relevant factors influencing development of chronic wounds,and to summarize the assessment,diagnosis and treatment of chronic wounds.Method: A total of 197 patients with chronic wounds were admitted to Burn Department from January 1,2018 to December 31,2018.Personal characteristics,morbid status,laboratory-related indicators,ulcer-related information,wound treatments,outcomes and hospitalization costs were evaluated in the light of patient’s age and wound etiology with IBM SPSS Statistics 20.Result: l.Chronic wound occurred much more frequently in middle-aged and elderly patients,and majority of them were over 40 years old(74.1%),while males(2/3)were dominated in each groups.The incidence of age-related diseases such as diabetes,hypertension and adverse lifestyle habits such as smoking and drinking had increased with age growing gradually;white blood cells,hemoglobin,platelets,albumin and other indicators disclosed that nutritional status had declined with age obviously,but no significant difference between groups in statistic.2.The leading causes of chronic wounds were burns(24.87%)and trauma(20.81%)in our department,while diabetes only accounting for 7.11%.Limbs were predilection sites for chronic wounds in different age groups,and those over 60 s had suffered more in lower extremities.3.The total amount of Chronic ulcers in each patient differed by injury factors(P <0.001).It’s usually just one single ulcer caused by arterial diseases of lower limbs or malignant tumors,but burns led to the maximum lesions(3.1 ± 2.1).Ranking areas of chronic wound were as follow: arterial diseases of the lower extremities(180.00 ± 169.71cm2),diabetes(77.82 ± 82.91cm2),surgery(73.07 ± 84.31 cm2),burns(72.05 ± 87.47cm2),and pressure ulcer at the end(27.40 ± 24.71 cm2).4.Granulation tissue was stale in 40.61% of chronic wounds,nearly all of which had some exudation.Full-thickness skins were affected in 98.98% of ulcers,and periosteum and bone marrow were involved in 34 cases.Gangrene cases was 10(5.08%)and osteomyelitis was 6(3.05%),all of which were identified in those over 60 s.5.158 chronic wound patients underwent wounds germiculture,and the positive rate was 61.39%.A total of 124 strains of bacteria were cultured.Most of the Gram-positive bacterium was Staphylococcus aureus,and Gram-negative bacterium were Acinetobacter baumannii,Pseudomonas aeruginosa,and Klebsiella pneumoniae.6.Debridement,systemic antibiotics,skin grafting,and partial application of antibacterial agents and growth factors were mainstream therapies for chronic wounds,while physical assisted treatments such as red/blue light and decompression mattresses were conventionally used in chronic wounds caused by burns and surgery.Totally,the healing rate was 73.10%,and 12 patients had an amputation,most of which were caused by severe trauma or infection.7.The medical insurances of chronic wound patients included basic medical insurance(33%)and own expense(66%)without any public or commercial medical insurance.Hospital stay of majority of inpatients was controlled within 3-4 weeks,though a few cases exceed 3 months.Of all inpatients,the length of hospital stay of burn-caused patients was the longest(up to 126 days),and average cost was the highest(195054.26 ± 381607.99 yuan),while carcinoma-related patients underwent the shortest hospital stay(15.4 ± 5.9 days)and the lowest cost(22952.71 ± 15137.35 yuan).Conclusion: Burns and trauma were the major cause of chronic wounds,which was tightly corresponding with aging.Of chronic wounds endured poor granulation tissue,most were subjected to exudation and infection.And surgery,as the primary therapy,was proved to be an effective approach for chronic wound’s treatment,nevertheless at a high cost. |
