Section of Dermatology, Department of Pediatrics, Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada.
J Am Acad Dermatol. 2012 Nov;67(5):904-17. doi: 10.1016/j.jaad.2012.01.016. Epub 2012 Mar 2.
Wound care is the cornerstone of treatment for patients with epidermolysis bullosa (EB); however, there are currently no guidelines to help practitioners care for these patients.
The objective of this study was to generate a list of recommendations that will enable practitioners to better care for patients with EB.
An expert panel generated a list of recommendations based on the best evidence available. The recommendations were translated into a survey, and sent to other EB experts to generate consensus using an online-based modified Delphi method. The list was refined and grouped into themes and specific recommendations.
There were 15 respondents (45% response rate), with significant experience in the EB field (>10 years [67%]). Respondents included physicians (67%), nurses (17%), and allied health professionals (7%). There was more than 85% agreement for all the proposed items. These were further refined and grouped into 5 main themes (assessment and management of factors that impair healing, patient-centered concerns, local wound care, development of an individualized care plan, and organizational support) and 17 specific recommendations.
There is a paucity of scientific evidence with most recommendations based on expert opinion.
These recommendations will provide practitioners with a framework for caring for these patients. Additional scientific research including effectiveness studies for everyday practice and expert consensus, may further refine these recommendations.
伤口护理是治疗大疱性表皮松解症(EB)患者的基石;然而,目前尚无指南帮助临床医生照顾这些患者。
本研究旨在制定一系列建议,使临床医生能够更好地照顾 EB 患者。
专家小组根据现有最佳证据制定了一系列建议。这些建议被转化为一项调查,并发送给其他 EB 专家,使用在线改良 Delphi 方法达成共识。该清单经过精炼并分为主题和具体建议。
共有 15 名受访者(45%的回复率),在 EB 领域拥有丰富的经验(>10 年[67%])。受访者包括医生(67%)、护士(17%)和专职医疗人员(7%)。所有提出的项目都有超过 85%的一致意见。这些建议进一步细化并分为 5 个主要主题(影响愈合的因素的评估和管理、以患者为中心的关注点、局部伤口护理、制定个体化护理计划和组织支持)和 17 个具体建议。
由于大多数建议基于专家意见,因此科学证据不足。
这些建议将为临床医生照顾这些患者提供框架。包括针对日常实践的有效性研究和专家共识在内的更多科学研究,可能会进一步完善这些建议。