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一家急症医院糖尿病足溃疡门诊的伤口愈合结果:一项回顾性研究。

Wound healing outcomes in a diabetic foot ulcer outpatient clinic at an acute care hospital: a retrospective study.

作者信息

Lu S H, McLaren A-M

机构信息

Chiropodist, Wound Care Team, St. Michael's Hospital, Toronto, Ontario, Canada.

出版信息

J Wound Care. 2017 Oct 1;26(Sup10):S4-S11. doi: 10.12968/jowc.2017.26.Sup10.S4.

Abstract

OBJECTIVE

Patients with diabetic foot ulcers (DFU) have an increased risk of lower extremity amputation. A retrospective chart review of patients with DFUs attending the Foot Treatment and Assessment chiropodist-led outpatient clinic at an inner-city academic hospital was conducted to determine wound healing outcomes and characteristics contributing to outcomes.

METHOD

We reviewed the complete clinical history of 279 patients with 332 DFUs spanning over a five-year period.

RESULTS

The mean age of patients was 61.5±12.5 years and most patients (83.5%) had one DFU. The majority of wounds (82.5%) were in the forefoot. Overall, 267/332 (80.5%) wounds healed. A greater proportion of wounds healed in the forefoot (82.5%) and midfoot (87.1%) than hindfoot (51.9%; p<0.001). Using a logistic regression model, palpable pedal pulse and use of a total contact cast were associated with better wound healing.

CONCLUSION

Our findings are the first to demonstrate the benefits of chiropodists leading an acute care outpatient clinic in the management of DFUs in Canada and delivers wound healing outcomes equivalent to or exceeding those previously published.

摘要

目的

糖尿病足溃疡(DFU)患者下肢截肢风险增加。对一家市中心学术医院由足病医生主导的足部治疗与评估门诊就诊的DFU患者进行回顾性病历审查,以确定伤口愈合结果及影响结果的特征。

方法

我们回顾了279例患者332处DFU在五年期间的完整临床病史。

结果

患者的平均年龄为61.5±12.5岁,大多数患者(83.5%)有一处DFU。大多数伤口(82.5%)位于前足。总体而言,267/332(80.5%)处伤口愈合。前足(82.5%)和中足(87.1%)愈合的伤口比例高于后足(51.9%;p<0.001)。使用逻辑回归模型,可触及的足部脉搏和使用全接触石膏与更好的伤口愈合相关。

结论

我们的研究结果首次证明了在加拿大,由足病医生主导急性护理门诊治疗DFU的益处,且伤口愈合结果等同于或超过先前发表的结果。

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