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[杜布拉瓦大学医院整形、重建与美容外科临床科室的压疮治疗经验:2011 - 2016年与2003 - 2008年期间记录结果的比较]

[PRESSURE ULCER TREATMENT EXPERIENCE AT CLINICAL DEPARTMENT OF PLASTIC, RECONSTRUCTIVE AND AESTHETIC SURGERY, DUBRAVA UNIVERSITY HOSPITAL: COMPARISON OF RESULTS RECORDED IN THE 2011-2016 AND 2003-2008 PERIOD].

作者信息

Budi S, Žic R, Martić K, Rudman F, Vlajčić Z, Milanović R, Roje Z, Munjiza A, Rajković I, Gorjanc B, Held R, Maletić A, Tucaković H, Stanec Z

出版信息

Acta Med Croatica. 2016;70 Suppl 1:11-6.

Abstract

Results of this clinical study on surgical treatment of pressure ulcers at Department of Plastic, Reconstructive and Aesthetic Surgery, Dubrava University Hospital showed that there was no difference between the 2011-2016 and 2003-2008 periods, indicating continuation of good surgical treatment planning and appropriate postoperative care. Despite the smaller number of hospitalized patients in the 2011-2016 period (31 patients and 42 reconstructive procedures), the number of reconstructive procedure was similar to the recent 2003-2008 period (47 patients and 57 reconstructive procedures). The best results of reconstruction of sacral region pressure ulcer were achieved with fasciocutaneous and musculocutaneous flaps. Whenever possible, depending on the extent of the defect, musculocutaneous flaps should be preferred for reconstruction. It is especially suitable for pressure ulcer recurrence. For ischial region reconstruction, good results can be obtained by mobilizing the semimembranosus and/or semitendinosus in defect gap. For trochanteric region, the tensor fascia lata flap is a good choice. For maximal functional and reconstructive results, a multidisciplinary approach in pressure ulcer treatment has the leading role in the modern concept of wound healing. Surgical treatment should always include radical debridement, ostectomy and well planned defect reconstruction. Conservative treatment should be support to surgical treatment with a focus on patient health care and high hygiene measures. In recent years (2011-2016), the usage of better conservative treatment led to reduction of patient hospital stay and surgical treatment of pressure ulcer. Further ‘wound care’ nurses training in Croatia can lead the trend towards advanced practice nursing in pressure ulcer prevention and conservative treatment.

摘要

杜布拉瓦大学医院整形、重建与美容外科对压疮手术治疗的这项临床研究结果表明,2011 - 2016年期间与2003 - 2008年期间并无差异,这表明良好的手术治疗规划和适当的术后护理得以延续。尽管2011 - 2016年期间住院患者数量较少(31例患者和42例重建手术),但重建手术的数量与2003 - 2008年近期期间相似(47例患者和57例重建手术)。采用筋膜皮瓣和肌皮瓣对骶部压疮进行重建可取得最佳效果。只要有可能,根据缺损范围,应优先选择肌皮瓣进行重建。它特别适用于压疮复发。对于坐骨区域重建,通过在缺损间隙中 mobilizing 半膜肌和/或半腱肌可获得良好效果。对于转子区域,阔筋膜张肌皮瓣是一个不错的选择。为了获得最大的功能和重建效果,多学科方法在压疮治疗中在现代伤口愈合概念中起主导作用。手术治疗应始终包括彻底清创、骨切除术和精心规划的缺损重建。保守治疗应辅助手术治疗,重点关注患者的医疗保健和高度卫生措施。近年来(2011 - 2016年),采用更好的保守治疗导致患者住院时间缩短以及压疮的手术治疗减少。在克罗地亚对“伤口护理”护士进行进一步培训可引领压疮预防和保守治疗方面向高级实践护理发展的趋势。

原文中“mobilizing”这个词在医学语境中可能有更准确的专业表述,这里直接保留英文是因为不太明确最合适的中文翻译,可能需要结合更详细的医学知识来确定准确翻译,比如“松解”等,但不确定是否完全准确。

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