Wei Z R, Huang G T
Department of Burns and Plastic Surgery, the Affiliated Hospital of Zunyi Medical University, Zunyi 563000, China.
Zhonghua Shao Shang Za Zhi. 2019 Nov 20;35(11):824-827. doi: 10.3760/cma.j.issn.1009-2587.2019.11.012.
With the change of disease spectrum and the progress in the aging of society, chronic wound has gradually become one of the major diseases that threaten human health, and also one of the major economic burdens of family and society. According to the different etiology, the pathogenesis of chronic wound is different, including both systemic factors and local factors. The treatment of chronic wound is a multi-disciplinary integrated treatment process, including internal medicine treatment, surgical treatment, vascular interventional therapy, platelet-rich plasma treatment, and biological therapy, etc. Each treatment regimen has its own indications and pros and cons. To make a treatment regimen, a combination of a variety of options should be chosen according to the patient's wound conditions. The traditional chronic wound treatment mode is multi-disciplinary team (MDT) treatment mode, which requires the participation of surgeons from multiple departments such as intervention department, plastic surgery department, orthopedics department, etc., and it is also the mainstream mode for treating chronic wound in western countries. According to the domestic medical situation and the experience of our department, we put forward the integrated surgical wound treatment (ISWT) mode, that is to integrate multiple surgical techniques of wound treatment. Compared with the traditional MDT treatment mode, to apply the ISWT mode can make a more reasonable treatment plan, improve the efficiency of diagnosis and treatment, shorten the hospitalization period, and improve the diagnosis and treatment ability of the team. With the increasing incidence of chronic wound, the ISWT mode needs to be further explored and improved, and the team needs more specialized experts to join in.
随着疾病谱的变化以及社会老龄化进程的推进,慢性伤口已逐渐成为威胁人类健康的主要疾病之一,也是家庭和社会的主要经济负担之一。根据病因不同,慢性伤口的发病机制各异,包括全身因素和局部因素。慢性伤口的治疗是一个多学科综合治疗过程,包括内科治疗、外科治疗、血管介入治疗、富血小板血浆治疗以及生物治疗等。每种治疗方案都有其适应证和优缺点。制定治疗方案时,应根据患者的伤口情况选择多种方案的组合。传统的慢性伤口治疗模式是多学科团队(MDT)治疗模式,这需要介入科、整形外科、骨科等多个科室的外科医生参与,也是西方国家治疗慢性伤口的主流模式。根据国内医疗情况及我科经验,我们提出了综合手术伤口治疗(ISWT)模式,即整合多种伤口治疗的手术技术。与传统的MDT治疗模式相比,应用ISWT模式可制定更合理的治疗方案,提高诊疗效率,缩短住院时间,并提升团队的诊疗能力。随着慢性伤口发病率的不断上升,ISWT模式需要进一步探索和完善,团队也需要更多专业专家的加入。