Wound care

伤口护理
  • 文章类型: Case Reports
    作者没有利益冲突。
    UNASSIGNED: The authors have no conflicts of interest.
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  • 文章类型: Journal Article
    皮肤手术的并发症风险非常低。没有被广泛接受,基于证据的协议,并建议皮肤科手术后的伤口护理。在这篇叙述性评论中,我们将讨论手术伤口护理产品和程序的证据。总的来说,我们发现相对较少的研究,在许多情况下,缺乏统计学上的显著差异,可能是因为并发症发生率低。我们将讨论何时启动伤口护理程序及其频率的证据,应该使用的软膏和防腐剂的类型,以及应该使用的敷料类型。尽管很少有关于皮肤科手术后伤口护理的研究,有足够的证据表明不建议使用预防性局部抗生素。我们还分析了目前在特殊情况下手术伤口护理的现有证据,例如皮肤移植的管理,部分皮肤移植供体部位,异种移植物/生物膜,和腿部的手术伤口。
    Dermatologic surgery is associated with a very low risk of complications. There is no widely accepted, evidence-based protocol with recommendations for postoperative wound care after dermatologic surgery. In this narrative review, we will be discussing the evidence on surgical wound care products and procedures. Overall, we found relatively few studies and, in many cases, a lack of statistically significant differences, possibly because of the low rate of complications. We\'ll be discussing the evidence on when we should initiate wound care procedures and their frequency, the type of ointment and antiseptics that should be applied, and the type of dressings that should be used. Despite the very few studies available on postoperative wound care following dermatologic surgery, there is sufficient evidence as to not recommend the use of prophylactic topical antibiotics. We also analyze the currently available evidence on surgical wound care in special situations, such as management of skin grafts, partial skin graft donor sites, xenografts/biomembranes, and surgical wounds to the legs.
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  • 文章类型: Journal Article
    总结临床使用0.1%聚己胺丙基甜菜碱(PHMB/甜菜碱)溶液/凝胶对急性和难以愈合(慢性)伤口愈合的影响的发现。
    在MEDLINE进行了文献检索,CINAHL,Embase,Scopus和Cochrane协作中心试验登记处。配对审稿人进行标题和摘要筛选和全文筛选,以确定实验,准实验和观察研究。没有对研究质量和偏倚风险进行正式评估。
    共有17项研究符合资格标准。来自12项研究的结果表明,使用0.1%PHMB/甜菜碱溶液/凝胶具有:接触敏感性风险低;可以在伤口清洁期间帮助清创;有助于有效的伤口床准备;减少伤口大小,气味和渗出物;改善疼痛控制;减少微生物负荷;并增强伤口愈合。三项研究的结果表明,0.1%PHMB和盐溶液均能有效减少细菌负荷,而另一项研究表明,在复合敷料中添加0.1%PHMB对降低伤口细菌负荷没有影响。另一项研究得出结论,与使用0.1%PHMB/甜菜碱相比,使用0.3%PHMB的水平衡敷料对压力性溃疡进行消毒和制粒更快,更有效。
    这篇文献综述的发现表明,0.1%PHMB/甜菜碱溶液/凝胶对于伤口清洁似乎是有用和安全的,能有效清除伤口床上的软碎片和腐肉,创造了一个最适合愈合的伤口环境。虽然这些行为不能完全归因于这种治疗方式,这些结果确实突出了这种组合产品的独特作用。然而,需要更有力的研究来证实这些结果.
    UNASSIGNED: To summarise the findings on the effect of the clinical use of 0.1% polyhexanide-propylbetaine (PHMB/betaine) solution/gel on acute and hard-to-heal (chronic) wound healing.
    UNASSIGNED: A literature search was conducted in MEDLINE, CINAHL, Embase, Scopus and the CENTRAL Trials Registry of the Cochrane Collaboration. Paired reviewers conducted title and abstract screening and full-text screening to identify experimental, quasi-experimental and observational studies. Study quality and risk of bias were not formally evaluated.
    UNASSIGNED: A total of 17 studies met the eligibility criteria. The findings from 12 studies indicated that the use of 0.1% PHMB/betaine solution/gel had: a low risk of contact sensitivity; could help debridement during wound cleansing; aided effective wound bed preparation; reduced wound size, odour and exudate; improved pain control; reduced microbial load; and enhanced wound healing. The results of three studies indicated that both 0.1% PHMB and saline solution were effective in reducing bacterial load, while another showed that adding 0.1% PHMB to tie-over dressings had no effect on reducing bacterial loads in wounds. Another study concluded that disinfection and granulation of pressure ulcers with hydrobalance dressing with 0.3% PHMB was faster and more effective than using 0.1% PHMB/betaine.
    UNASSIGNED: The findings of this literature review showed that 0.1% PHMB/betaine solution/gel appeared to be useful and safe for wound cleansing, was effective in removing soft debris and slough from the wound bed, and created a wound environment optimal for healing. Although these actions cannot be attributed solely to this treatment modality, these results do highlight the unique action of this combined product. However, more robust studies are needed to confirm these results.
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  • 文章类型: Systematic Review
    本系统评价的目的是确定和鉴定伤口渗出物处理能力和水合反应技术(HRT)的成本效益的当前可用证据。HRT结合了物理改性的纤维素纤维和胶凝剂,产生吸收和保留更大量的伤口渗出物的伤口敷料。
    在MEDLINE(通过PubMed和PubMedCentral)中,根据系统评价和荟萃分析(PRISMA)的首选报告项目进行系统检索。使用无限制的搜索周期进行搜索。评估对伤口渗出物和成本效益的影响的研究或评论,以及对伤口愈合的影响。包括关注使用HRT设备的伤口管理的记录。
    文献检索确定了四项研究和一项比较分析,从低质量到中等质量,将HRT敷料与其他干预措施(羧甲基纤维素敷料,其他超吸收敷料,负压伤口治疗)。
    分析的数据支持HRT敷料对渗出伤口的有益使用,其特点是敷料更换次数较少,改善伤口周围的皮肤状况和降低成本。
    UNASSIGNED: The aim of this systematic review was to identify and qualify the current available evidence of the wound exudate handling capabilities and the cost-effectiveness of hydration response technology (HRT). HRT combines physically modified cellulose fibres and gelling agents resulting in wound dressings that absorb and retain larger quantities of wound exudate.
    UNASSIGNED: A systematic search was conducted in MEDLINE (via PubMed and PubMed Central) according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The search was conducted using an unlimited search period. Studies or reviews that evaluated effect on wound exudate and cost-effectiveness, as well as the impact on wound healing were considered. Records focusing on wound management using HRT devices were included.
    UNASSIGNED: The literature search identified four studies and one comparative analysis, ranging from low to moderate quality, that compared HRT dressings to other interventions (carboxymethyl cellulose dressing, other superabsorbent dressings, negative pressure wound therapy).
    UNASSIGNED: The analysed data supported the beneficial use of dressings with HRT for exuding wounds which was characterised by fewer dressing changes, improved periwound skin conditions and reduced costs.
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  • 文章类型: Journal Article
    糖尿病足伤口和感染在糖尿病护理中构成了重大且不断发展的挑战。糖尿病伤口愈合已成为全球关注的主要问题。已经进行了持续的研究以将糖尿病溃疡的愈合过程提高到截肢率。由于各种情况,糖尿病患者的伤口愈合时间延长,比如高葡萄糖水平,神经病,血液循环不良,和四肢周围的长期炎症,与正常患者相比,导致愈合延迟。了解慢性足部伤口的复杂性以及管理和适当的治疗将降低截肢的风险。世界各地的医疗团队一直在研究降低风险。这篇综述论文提供了一个令人信服的旅程,穿越了糖尿病足伤口和感染的多方面世界。它强调了理解分类的紧迫性,解决多药耐药性,并利用微生物的见解彻底改变糖尿病足并发症的治疗和管理。此外,它揭示了最先进的诊断方法,预示着在与这种使人衰弱的糖尿病并发症的斗争中更光明的未来。
    Diabetic foot wounds and infections pose a significant and evolving challenge in diabetes care. Diabetic wound healing has become a major global concern for a very long time. Continuous research has been conducted to increase the healing process in diabetic ulcers to the rate of amputation. Wound healing is prolonged in diabetic patients due to various conditions, such as high glucose levels, neuropathy, poor blood circulation, and prolonged inflammation around the limbs, which causes the healing to be delayed compared to normal patients. Understanding the complexity of chronic foot wounds and the management and proper treatment would lead to a decrease in the risk of amputation. The medical team all over the world is constantly researching to lower the risk. This review paper offers a compelling journey through the multifaceted world of diabetic foot wounds and infections. It underscores the urgency of understanding classification, tackling multidrug resistance, and harnessing microbial insights to revolutionize the treatment and management of diabetic foot complications. Furthermore, it unveils state-of-the-art diagnostics, heralding a brighter future in the battle against this debilitating complication of diabetes.
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  • 文章类型: Journal Article
    由于其丰富的天然可用性,多糖是伤口护理应用的有利和有前途的生物聚合物。低成本和优异的生物相容性。它们拥有不同的官能团,如羧基,羟基和氨基,并且可以容易地修改以获得期望的性质和各种形式。这篇综述系统地分析了多糖衍生材料在伤口护理中的应用的最新进展,强调最常用的纤维素,壳聚糖,海藻酸盐,淀粉,葡聚糖和透明质酸衍生材料。详细讨论了每种多糖衍生的伤口护理材料的独特属性,以及它们不同的形式,即,电影,膜,海绵,纳米乳液,纳米纤维,脚手架,纳米复合材料和水凝胶。还总结了开发多糖衍生的伤口护理材料的加工方法。最后,列出了与创伤护理管理中的多糖衍生材料相关的挑战,并提出了未来扩大其利用率以与常规伤口愈合材料竞争的建议。
    Polysaccharides are favourable and promising biopolymers for wound care applications due to their abundant natural availability, low cost and excellent biocompatibility. They possess different functional groups, such as carboxylic, hydroxyl and amino, and can easily be modified to obtain the desirable properties and various forms. This review systematically analyses the recent progress in polysaccharides derived materials for wound care applications, emphasizing the most commonly used cellulose, chitosan, alginate, starch, dextran and hyaluronic acid derived materials. The distinctive attributes of each polysaccharide derived wound care material are discussed in detail, along with their different forms, i.e., films, membranes, sponges, nanoemulsions, nanofibers, scaffolds, nanocomposites and hydrogels. The processing methods to develop polysaccharides derived wound care materials are also summarized. In the end, challenges related to polysaccharides derived materials in wound care management are listed, and suggestions are given to expand their utilization in the future to compete with conventional wound healing materials.
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  • 文章类型: Journal Article
    糖尿病足溃疡(DFU)是一个重要的健康问题,特别是在低收入和中等收入国家(LMICs)。这篇综述探讨了在LMIC中管理DFU的关键策略,包括整合足病,内分泌学,和伤口护理服务,教育病人,促进自我照顾,以及降低截肢率的预防措施。
    进行了全面的文献综述,侧重于在低收入和中等收入国家进行的研究,以促进定性分析。这篇综述研究了发展DFU的病因和危险因素,临床表现,多学科管理和循证干预,对提供护理和未来方向的挑战,所有这些都与低收入和中等收入国家的DFU有关。
    导致DFU发展的病因和危险因素是复杂和多方面的。获得医疗保健的机会有限等因素,糖尿病管理不足,社会经济差异显著影响DFU的发病率。临床表现各不相同,由于延误或漏诊,患者通常处于疾病的晚期。多学科管理,结合足病,内分泌学,和伤口护理服务,在提高患者预后方面表现出实质性的希望。循证干预措施,包括卸载技术,伤口清创术,使用先进的伤口敷料,已证明有效促进溃疡愈合。
    在LMIC中,DFU的负担需要全面的策略。整合足病,内分泌学,和伤口护理服务,随着病人的教育和自我护理实践,对于减少截肢和改善患者的生活质量至关重要。定期随访和早期发现对于有效的DFU管理至关重要,强调需要对LMIC医疗保健基础设施进行持续的研究和投资。拥抱这些多学科,以患者为中心的方法可以有效应对低收入国家DFU的挑战,导致更好的患者预后和提高生活质量。
    UNASSIGNED: Diabetic Foot Ulcers (DFUs) are a significant health concern, particularly in Low- and Middle-Income Countries (LMICs). This review explores key strategies for managing DFUs in LMICs, including integrating podiatry, endocrinology, and wound care services, educating patients, promoting self-care, and preventive measures to reduce amputation rates.
    UNASSIGNED: A comprehensive literature review was conducted, focusing on studies conducted in Low and Middle Income Countries to facilitate a qualitative analysis. The review examined the aetiology and risk factors to developing DFUs, clinical presentation, multidisciplinary management and evidence based interventions, challenges to the provision of care and future directions, all pertaining to DFUs in low and middle income countries.
    UNASSIGNED: The aetiology and risk factors contributing to the development of DFUs are complex and multifaceted. Factors such as limited access to health care, inadequate diabetes management, and socioeconomic disparities significantly influence the incidence of DFUs. Clinical presentation varies, with patients often presenting at advanced stages of the disease due to delayed or missed diagnoses. Multidisciplinary management, incorporating podiatry, endocrinology, and wound care services, has exhibited substantial promise in enhancing patient outcomes. Evidence-based interventions, including offloading techniques, wound debridement, and the use of advanced wound dressings, have proven effective in promoting ulcer healing.
    UNASSIGNED: The burden of DFUs in LMICs requires comprehensive strategies. Integrating podiatry, endocrinology, and wound care services, along with patient education and self-care practices, is essential for reducing amputations and improving patients\' quality of life. Regular follow-up and early detection are vital for effective DFU management, emphasizing the need for ongoing research and investment in LMIC health care infrastructure. Embracing these multidisciplinary, patient-centered approaches can effectively address the challenge of DFUs in LMICs, leading to better patient outcomes and improved quality of life.
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  • 文章类型: Journal Article
    系统评价的目的是检查和总结文献中关于使用关键绩效指标(KPI)来评估难以愈合(复杂)伤口患者的伤口护理计划和服务的现有证据。随着人口的持续老龄化和由此导致的慢性病症的发展,预期对伤口护理的需求将增长。这种预期的增长需要改善伤口护理计划和服务及其提供质量的能力,基于证据和成本效益的做法。目前的文献缺乏对KPI的系统评估,无法为评估各种环境中的伤口护理服务和计划提供信息。以及如何使用KPI来提高伤口护理质量并达到预期效果。该协议规定了如何进行系统审查。
    将从MEDLINE、CINAHL和Scopus,从Google学者和ProQuest论文和论文中检索到未发表的研究和灰色文献。研究标题和摘要将由两名独立审稿人筛选,使用Covidence系统审查软件确保他们符合纳入标准,然后,谁将使用标准化数据提取工具进行全文的数据提取。将筛选用于关键评估的所有研究的参考列表,以查找其他出版物。两位独立审稿人将使用JBISUMARI的适当清单批判性地评估所有正在进行全文数据提取的研究。在所有阶段,审稿人之间的分歧将通过讨论解决,通过三分之一的裁决,独立审稿人。
    将对数据点进行描述性统计和分组分析,根据节目特点和出版状况。灰色文献和同行评审的出版物将形成单独的分析。要回答复习问题,数据将以叙述格式汇总。没有计划进行荟萃分析。在撰写本文时,该协议已实施到初步文献检索。
    这篇综述将解决当前的文献空白,并系统地确定伤口护理中的KPI,允许计划评估其护理质量并有条不紊地改善服务。
    UNASSIGNED: The objective of the systematic review is to examine and summarise the available evidence in the literature of the use of key performance indicators (KPIs) to inform evaluation of wound care programmes and services for people with hard-to-heal (complex) wounds. The need for wound care is expected to grow with the continued ageing of the population and the resulting increased development of chronic conditions. This expected increase necessitates improvement of wound care programmes and services and their ability to deliver quality, evidence-based and cost-effective practice. The current literature lacks a systematic assessment of KPIs to inform evaluation of wound care services and programmes across various settings, and how the KPIs are used to improve the quality of wound care and achieve desired outcomes. This protocol sets out how the systemtic review will be undertaken.
    UNASSIGNED: Primary studies will be screened from databases such as MEDLINE, CINAHL and Scopus, with unpublished studies and grey literature retrieved from Google Scholar and ProQuest Dissertations and Theses. The study titles and abstracts will be screened by two independent reviewers, using Covidence systematic review software to ensure they meet the inclusion criteria, who will then proceed with data extraction of the full-text using the standardised data extraction instrument. The reference lists of all studies selected for critical appraisal will be screened for additional publications. The two independent reviewers will critically appraise all studies undergoing full-text data extraction using the appropriate checklist from JBI SUMARI. At all stages, differences between reviewers will be resolved through discussion, with adjudication by a third, independent reviewer.
    UNASSIGNED: Data points will be analysed with descriptive statistics and grouped, based on programme characteristics and publication status. Grey literature and peer-reviewed publications will form separate analyses. To answer review questions, the data will be summarised in a narrative format. A meta-analysis is not planned. At the time of writing, this protocol has been implemented up to the preliminary literature search.
    UNASSIGNED: This review will address a current literature gap and systematically identify KPIs in wound care, allowing for programmes to evaluate their quality of care and improve their services in a methodical manner.
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  • 文章类型: Meta-Analysis
    准确评估烧伤深度和烧伤伤口愈合潜力对于确定早期治疗至关重要。红外热成像(IRT)是一种非侵入性和客观的工具。这项系统评价评估了IRT确定烧伤伤口愈合潜力的准确性。
    本系统综述和荟萃分析使用MEDLINE,EMBASE,CINAHL,PEDro,DiTA和CENTRAL数据库。IRT数据是从初级研究中提取的,并分类为四个细胞(即,真正的积极因素,假阳性,真阴性和假阴性)。根据用于捕获热图像的方法进行亚组分析。
    搜索策略确定了2727种出版物;但是,选择15篇文章进行综述,11篇进行荟萃分析。在我们的荟萃分析中,IRT的准确性为84.8%(63%的敏感性和81.9%的特异性).
    IRT是识别烧伤深度和愈合潜力的中等精确工具。因此,应仔细使用IRT评估烧伤创面。
    UNASSIGNED: Accurate assessment of burn depth and burn wound healing potential is essential to determine early treatments. Infrared thermography (IRT) is a non-invasive and objective tool to do this. This systematic review evaluated the accuracy of IRT to determine burn wound healing potential.
    UNASSIGNED: This systematic review and meta-analysis used MEDLINE, EMBASE, CINAHL, PEDro, DiTA and CENTRAL databases. IRT data were extracted from primary studies and categorised into four cells (i.e., true positives, false positives, true negatives and false negatives). Subgroup analysis was performed according to methods used to capture thermal images.
    UNASSIGNED: The search strategy identified 2727 publications; however, 15 articles were selected for review and 11 for meta-analysis. In our meta-analysis, the accuracy of IRT was 84.8% (63% sensitivity and 81.9% specificity).
    UNASSIGNED: IRT is a moderately accurate tool to identify burn depth and healing potential. Thus, IRT should be used carefully for evaluating burn wounds.
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  • 文章类型: Review
    对伤口的有效评估,既急性又难以治愈,是伤口护理从业者为患者提供有效伤口护理的重要组成部分。改善伤口诊断,优化伤口治疗方案,和增强的伤口预防有助于为患者提供更好的生活质量(QoL)。人工智能(AI)在伤口护理等健康相关领域的应用潜力巨大。然而,基于AI的系统仍有待开发到可以在临床上用于提供高质量伤口护理的程度。我们对AI在诊断中的发展和使用进行了叙述性回顾,难以愈合的伤口的评估和治疗。我们从几个在线数据库和其他在线资源中检索了145篇文章,其中81人被纳入本叙述性审查。我们的评论显示,人工智能在伤口护理中的应用在评估/诊断方面提供了好处,监测和治疗急性和难以愈合的伤口。除了为患者提供改善QoL的潜力外,AI还可以更好地利用医疗保健资源。
    UNASSIGNED: The effective assessment of wounds, both acute and hard-to-heal, is an important component in the delivery by wound care practitioners of efficacious wound care for patients. Improved wound diagnosis, optimising wound treatment regimens, and enhanced prevention of wounds aid in providing patients with a better quality of life (QoL). There is significant potential for the use of artificial intelligence (AI) in health-related areas such as wound care. However, AI-based systems remain to be developed to a point where they can be used clinically to deliver high-quality wound care. We have carried out a narrative review of the development and use of AI in the diagnosis, assessment and treatment of hard-to-heal wounds. We retrieved 145 articles from several online databases and other online resources, and 81 of them were included in this narrative review. Our review shows that AI application in wound care offers benefits in the assessment/diagnosis, monitoring and treatment of acute and hard-to-heal wounds. As well as offering patients the potential of improved QoL, AI may also enable better use of healthcare resources.
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