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在美国一家退伍军人医院门诊伤口中心使用具有完整细胞外基质的绵羊胶原蛋白敷料以缩短伤口愈合时间并降低费用。

Use of an Ovine Collagen Dressing with Intact Extracellular Matrix to Improve Wound Closure Times and Reduce Expenditures in a US Military Veteran Hospital Outpatient Wound Center.

作者信息

Ferreras Daniel T, Craig Sean, Malcomb Rebecca

机构信息

Surgical Services, Carl Vinson VA Medical Center, Dublin, Georgia.

Alexandria VA Health Care System, Pineville, Louisiana.

出版信息

Surg Technol Int. 2017 Jul 25;30:61-69.

Abstract

A novel, comprehensive decision-making and treatment algorithm was established within a US government-run military veteran hospital in an attempt to standardize the process of outpatient wound care and streamline costs. All patients were systematically evaluated and treated using the comprehensive algorithm over a span of nine months. After three months of adherence to the algorithm, the algorithm was modified to include ovine-based collagen extracellular matrix (CECM) dressings as a first-line conventional treatment strategy for all appropriate wounds. The purpose of this retrospective analysis was to evaluate the hospital's change in cellular and/or tissue-based graft usage and cost, as well as wound healing outcomes following modification of the wound care standardization algorithm. Data from the first quarter (Q1; three months) of protocol implementation were compared to the subsequent two quarters (six months), during which time the first-line dressing modification of the protocol was implemented. Results showed that between quarters 1 and 3, the percentage of wounds healed increased by 95.5% (24/64 to 80/109), and the average time to heal each wound decreased by 22.6% (78.8 days to 61.0 days). Cellular and/or tissue-based graft unit usage decreased by 59.7% (144 units to 58 units), and expenditures on cellular and/or tissue-based grafts decreased by 66.0% ($212,893 to $72,412). Results of this analysis displayed a trend toward decreased expenditures, faster healing times, and a greater number of healed wounds following modification of an evidence-based algorithm to incorporate CECM dressings as a first-line treatment strategy in managing chronic wounds.

摘要

在美国一家政府运营的退伍军人医院内,建立了一种新颖、全面的决策与治疗算法,旨在规范门诊伤口护理流程并简化成本。在九个月的时间里,所有患者均使用该综合算法进行系统评估和治疗。在遵循该算法三个月后,算法进行了修改,将基于羊胶原蛋白的细胞外基质(CECM)敷料纳入所有合适伤口的一线常规治疗策略。这项回顾性分析的目的是评估医院在细胞和/或组织基移植物使用及成本方面的变化,以及伤口护理标准化算法修改后的伤口愈合结果。将方案实施第一季度(Q1;三个月)的数据与随后两个季度(六个月)的数据进行比较,在这期间实施了方案的一线敷料修改。结果显示,在第1季度和第3季度之间,伤口愈合的百分比增加了95.5%(从24/64增至80/109),每个伤口的平均愈合时间减少了22.6%(从78.8天降至61.0天)。细胞和/或组织基移植物的使用量减少了59.7%(从144单位降至58单位),细胞和/或组织基移植物的支出减少了66.0%(从212,893美元降至72,412美元)。该分析结果显示出一种趋势,即在将基于证据的算法修改为纳入CECM敷料作为管理慢性伤口的一线治疗策略后,支出减少、愈合时间加快且愈合伤口数量增加。

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