慢性伤口的循证管理

Evidence-based management of chronic wounds.

作者信息

Jones Katherine R, Fennie Kristopher, Lenihan Amber

机构信息

Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA.

出版信息

Adv Skin Wound Care. 2007 Nov;20(11):591-600. doi: 10.1097/01.ASW.0000284936.32707.8d.

Abstract

OBJECTIVE

Identify the consistency of current chronic wound care practices with evidence-based recommendations for wound management.

DESIGN

A retrospective study based on 400 subject records (venous ulcers, 183; diabetic ulcers, 103; and pressure ulcers, 114). Study records were located at hospitals, wound care centers and clinics, home health agencies, and nursing homes in 4 diverse geographic locations.

METHODS

Chronic wound assessment and evidence-based treatment practices were identified by extensive review of the literature, professional Web sites, and the Agency for Healthcare Research and Quality National Guideline Clearinghouse. Actual delivery of wound care practices was obtained from retrospective chart reviews and a structured data abstraction protocol. Collected data were then compared with recommended practices for consistency, adherence variations, and wound healing across data collection sites.

RESULTS

Significant variations occurred in adherence to evidence-based recommendations across sites of care delivery, with selection and application of appropriate dressings showing the greatest need for improvement.

CONCLUSIONS

Current chronic wound care practices are inconsistent with evidence-based recommendations for wound management. Further studies are needed to determine the best method for translating this information to multiple settings.

摘要

目的

确定当前慢性伤口护理实践与基于证据的伤口管理建议之间的一致性。

设计

一项基于400份受试者记录的回顾性研究(静脉性溃疡183例、糖尿病性溃疡103例、压疮114例)。研究记录来自4个不同地理位置的医院、伤口护理中心和诊所、家庭健康机构及疗养院。

方法

通过广泛查阅文献、专业网站以及医疗保健研究与质量局国家指南库,确定慢性伤口评估和基于证据的治疗方法。伤口护理实践的实际实施情况通过回顾性病历审查和结构化数据提取协议获得。然后将收集的数据与推荐方法进行比较,以分析不同数据收集地点在一致性、依从性差异和伤口愈合方面的情况。

结果

在不同护理地点,对基于证据的建议的依从性存在显著差异,在选择和应用合适的敷料方面最需要改进。

结论

当前慢性伤口护理实践与基于证据的伤口管理建议不一致。需要进一步研究以确定将该信息转化到多种环境的最佳方法。

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