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在一个英格兰医疗保健区内的伤口护理调查中所确定的急性伤口的患病率、处理情况及转归。

The prevalence, management and outcome for acute wounds identified in a wound care survey within one English health care district.

作者信息

Vowden Kathryn R, Vowden Peter

机构信息

Bradford Teaching Hospitals NHS Foundation Trust & University of Bradford, UK.

出版信息

J Tissue Viability. 2009 Feb;18(1):7-12. doi: 10.1016/j.jtv.2008.11.004.

Abstract

This paper reports the characteristics and local management of 826 acute wounds identified during an audit across all health care providers serving the population of Bradford, UK. Of the wounds encountered 303 were traumatic wounds and 237 primary closures with smaller numbers of other acute wound types. Of the 303 traumatic wounds 174 occurred in women (57.4%). Men predominated in the under 45s (65M:26F), this being largely accounted for by hand and finger trauma (n = 62) particularly in patients of working age (M32:F12). Women predominated in the over 65s (50M:130F), this being largely accounted for by lower limb traumatic wounds (M24:F91), the majority of these being in patients 65 and over (M14:F82). In this sub-group of 96 patients 25 had wounds of 6 weeks or longer duration, only 3 had undergone Doppler assessment and only 2 received compression bandaging. Typically these wounds were of recent origin and small in size (under 1 week and less than 5 cm2 in surface area) however exceptions occurred where 10 people had wounds over 25 cm2 in area while 3 wounds had been present for over 5 years. 101 (12.2%) of the encountered wounds were considered to be infected although the practice of wound swabbing in the presence of presumed infection seemed inadequate with 37.6% of all infected acute wounds not being swabbed while 97 non-infected wounds were swabbed. Where wounds were swabbed 4.5% were found to be MRSA positive. Across all acute wound types (with the sole exception of primary closures) antimicrobial wound dressings were the most prevalent form of dressing and covered 56 (55.4%) of all infected wounds.

摘要

本文报告了在对英国布拉德福德地区所有医疗服务提供者进行的一次审计中发现的826例急性伤口的特征及当地处理情况。在这些伤口中,303例为创伤性伤口,237例为一期缝合伤口,其他急性伤口类型的数量较少。在303例创伤性伤口中,174例发生在女性患者身上(占57.4%)。45岁以下男性居多(65例男性:26例女性),这主要是由于手部和手指创伤(n = 62),尤其是在工作年龄的患者中(男性32例:女性12例)。65岁以上女性居多(50例男性:130例女性),这主要是由于下肢创伤性伤口(男性24例:女性91例),其中大多数患者年龄在65岁及以上(男性14例:女性82例)。在这96例患者的亚组中,25例伤口持续时间为6周或更长,只有3例接受了多普勒评估,只有2例接受了加压包扎。通常这些伤口是近期出现的,且面积较小(1周以内且表面积小于5平方厘米),但也有例外情况,10人伤口面积超过25平方厘米,3例伤口已存在5年以上。尽管在疑似感染时进行伤口拭子检查的做法似乎并不充分,所有感染的急性伤口中有37.6%未进行拭子检查,而97例未感染伤口进行了拭子检查,但仍有101例(12.2%)遇到的伤口被认为受到感染。在进行拭子检查的伤口中,4.5%被发现耐甲氧西林金黄色葡萄球菌(MRSA)呈阳性。在所有急性伤口类型中(一期缝合伤口除外),抗菌伤口敷料是最普遍的敷料形式,覆盖了所有感染伤口的56例(占55.4%)。

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