Olivieri Brandon, Yates Timothy E, Vianna Sofia, Adenikinju Omosalewa, Beasley Robert E, Houseworth Jon
Department of Interventional Radiology, Mount Sinai Medical Center, Miami, Florida.
School of Podiatric Medicine, Barry University, Miami, Florida.
Semin Intervent Radiol. 2018 Dec;35(5):406-426. doi: 10.1055/s-0038-1676342. Epub 2019 Feb 5.
Clinical outcomes in patients with critical limb ischemia (CLI) depend not only on endovascular restoration of macrovascular blood flow but also on aggressive periprocedural wound care. Education about this area of CLI therapy is essential not only to maximize the benefits of endovascular therapy but also to facilitate participation in the multidisciplinary care crucial to attaining limb salvage. In this article, we review the advances in wound care products and therapies that have granted the wound care specialist the ability to heal previously nonhealing wounds. We provide a primer on the basic science behind wound healing and the pathogenesis of ischemic wounds, familiarize the reader with methods of tissue viability assessment, and provide an overview of wound debridement techniques, dressings, hyperbaric therapy, and tissue offloading devices. Lastly, we explore emerging technology on the horizons of wound care.
严重肢体缺血(CLI)患者的临床结局不仅取决于大血管血流的血管内恢复,还取决于积极的围手术期伤口护理。关于CLI治疗这一领域的教育至关重要,这不仅是为了最大化血管内治疗的益处,也是为了促进参与对实现肢体挽救至关重要的多学科护理。在本文中,我们回顾了伤口护理产品和疗法的进展,这些进展使伤口护理专家有能力治愈以前无法愈合的伤口。我们提供了伤口愈合背后的基础科学以及缺血性伤口发病机制的入门知识,使读者熟悉组织活力评估方法,并概述伤口清创技术、敷料、高压氧治疗和组织减压装置。最后,我们探索伤口护理领域即将出现的新兴技术。