| Background:With the continuous improvement of people’s living standard,the prevalence of diabetes is increasing year by year.As a common endocrine-metabolism-related disease,chronic wounds with diabetes mellitus are often prone to wound infection and slow to heal,often requiring surgery to repair the wound.Promoting wound healing is the ultimate goal of wound care,and wound assessment is an essential aspect of achieving this goal.The formulation of a good,reasonable and safe treatment and nursing plan is inseparable from the scientific evaluation of the wound.In view of the close relationship between wound standardized evaluation and treatment outcome,it is of great clinical significance to develop standardized and unified wound evaluation criteria.The Bates-Jensen Wound Assessment Tool（BWAT）is an evaluation tool that includes 13 wound characteristics and is widely used in Europe,America and other countries.Recent studies have shown that BWAT has important clinical application value in the evaluation of wound healing in various diseases,and can timely evaluate the changes of patients’wounds and the effect of treatment.At present,there is no research report on the application of BWAT in wound healing of diabetic patients with wound infection in China.Therefore,this study intends to use BWAT to evaluate the wound healing of diabetic patients with wound infection and non-diabetic wound infection patients within 2 weeks after surgery,in order to provide a basis for the clinical application of BWAT.For patients with diabetes and wound infection,traditional wound dressing is the main treatment for postoperative wounds.The treatment effect is general and the wound healing time is slow and easy to relapse,which causes great pain and financial burden to patients.Negative pressure wound therapy（NPWT）,also known as vacuum-assisted closure（VAC）,is a new wound healing technique.By combining modern closed dressings with traditional negative pressure drainage technology,it can continuously or intermittently generate adsorption at the wound surface,so that the wound can be obtained.The lower pressure can promote wound healing,inhibit the growth of bacteria,and reduce the pain and treatment burden of patients.Currently,NPWT has been widely used in the treatment of penetrating wounds,soft tissue injuries,osteofascial incisions and open fractures.Therefore,this study intends to use NPWT to observe the wound healing and healing time of diabetic patients with wound infection within 2 weeks after surgery,in order to provide a basis for the application of NPWT in postoperative wound treatment of diabetic patients with wound infection.Part I Application of Bates-Jensen Wound Assessment Tool in wound healing of diabetic patients with wound infectionObjectiveTo evaluate the application effect of Bates-Jensen Wound Assessment Tool（BWAT）in wound healing after surgery in patients with diabetes and wound infection.MethodsA total of 33 patients with diabetes and wound infection were selected as the patient group,and 33 patients with wound infection without diabetes were selected as the control group.The wound healing was evaluated by BWAT before surgery,3 days,1week and 2 weeks after surgery.The BWAT scores and days of wound healing were compared between the two groups.SPSS 17.0 statistical software was used for data analysis.The gender differences between the two groups were analyzed by chi-square test.The age,body mass index（BMI）,and healing days of the two groups were analyzed by t test.The BWAT scores of the two groups of patients were analyzed by repeated measures analysis of variance.ResultsThe age of the patients in the control group was（67.36±2.07）years old,and the age of the patients in the diabetes group was（65.15±2.45）years old,and there was no significant difference between the two groups（t=0.689,P=0.493）.There were 24males and 9 females in the control group,22 males and 11 females in the diabetes group,and there was no significant difference in gender between the two groups（χ~2=0.287,P=0.592）.The BMI of the control group was（21.99±0.54）kg/m~2,and the BMI of the diabetic group was（22.77±0.57）kg/m~2,and there was no significant difference between the two groups.The wound healing time in the control group was（20.48±3.58）days,and the wound healing time in the diabetes group was（29.67±4.13）days.Compared with the diabetes group,the two groups showed an increasing trend,but the difference was not statistically significant（t=-1.680,P=0.098）.The results of repeated measures ANOVA showed that time factor affected the score of BWAT（F=385.901,P<0.001）,with an interactive effect（F=4.610,P<0.004）.Compared with the control group,the scores of BWAT in the diabetic group on the third day（t=2.251,P=0.017）and one week（t=2.537,P=0.014）after surgery were significantly higher.After 2 weeks,the BWAT score of the diabetic group had an increasing trend compared with the control group,but the difference was not statistically significant（t=1.701,P=0.094）.ConclusionBWAT could effectively evaluate wound healing in diabetic patients with wound infection,which can be widely used in clinical practice.Clinicians and nurses can formulate corresponding treatment and nursing plans according to the BWAT score,and dynamically record the patient’s BWAT score to adjust and optimize the plan and promote the patient’s wound healingPart II Application of Negative Pressure Wound Therapy in postoperative wound treatment of diabetic patients with wound infectionObjectiveTo evaluate the application effect of negative pressure wound therapy（NPWT）on wound healing after surgery in patients with diabetes and wound infection.MethodsA total of 60 patients with diabetes and wound infection were selected.The patients were divided into a treatment group and a control group,with 30 patients in each group,and were treated with vacuum sealing drainage and conventional dressing method,respectively.The wound healing was evaluated by Bates-Jensen Wound Assessment Tool（BWAT）before surgery,3 days,1 week and 2 weeks after surgery.The BWAT scores and days of wound healing were compared between the two groups.ResultsThe age of the patients in the control group was（59.87±2.83）years old,and the age of the patients in the treatment group was（64.60±2.69）years old,and there was no significant difference between the two groups（t=-1.213,P=0.230）.There were 14males and 16 females in the control group,18 males and 12 females in the treatment group,and there was no significant difference in gender between the two groups（χ~2=1.071,P=0.301）.The BMI of the control group was（22.79±0.57）kg/m~2,and the BMI of the treatment group was（22.73±0.54）kg/m~2,and there was no significant difference between the two groups.The wound healing time of the patients in the control group was（30.20±5.05）days,and the wound healing time of the patients in the treatment group was（18.40±1.41）days.The wound healing time of the patients in the treatment group was significantly decreased,and the difference was statistically significant（t=2.250,P=0.028）.The results of repeated measures ANOVA showed that time factor affected the score of BWAT（F=485.94,P<0.001）,with an interactive effect（F=4.421,P=0.020）.The BWAT scores of the patients in the treatment group were significantly lower than those in the control group at 1 week（t=-2.028,P=0.048）and 2 weeks（t=-2.652,P=0.011）after surgery.ConclusionNPWT can effectively improve the wound healing of patients with diabetes complicated with wound infection,reduce the frequency and pain of dressing change,reduce the workload of medical staff,help to save resources,reduce the disease burden of patients,and significantly improve the quality of life of patients,and can be widely used in clinical practice. |
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