Department of Orthopedics, The First Affiliated Hospital, College of Medicine, Zhejiang University, #79 Qingchun Road, Hangzhou, 310003, Zhejiang Province, People's Republic of China.
J Orthop Surg Res. 2020 Oct 2;15(1):452. doi: 10.1186/s13018-020-01976-0.
A large number of cases of pneumonia caused by novel β-coronavirus emerged in Hubei Province, China, at the end of 2019 and demonstrated great potential for transmission. At present, known independent risk factors include age, diabetes, and other chronic diseases, which may be similar to the patients with chronic wound; thus, we try to explore the clinical characteristics, prognostic factors, and management recommendation of patients with chronic infective wounds during the COVID-19 epidemic period.
In this single-center, retrospective observational study, we included all cases with chronic infective wounds that came to our hospital between the full outbreak of the COVID-19 in China (January 23, 2020) and the latest date prior to posting (20 April 2020). Demographic data, comorbidities, laboratory and imaging findings, consultation history, and clinical outcomes (lesion cured, uncontrolled, amputated, etc. as of May 10, 2020) were collected for all individuals. Patients were subdivided into gangrene, traumatic infection, and other types of soft tissue infection wound (including bedsores, gout ruptures, stab wounds, and so on) according to the causes of wound, and their disease-related information were compared group by group.
Among the total 81 patients with chronic infective wounds, 60% were male, with a mean age of 60.8 years (SD 18.6), including 38 (47%) patients with traumatic infection, 29 (36%) gangrene cases, and 14 (17%) other soft tissue infection wounds. Common comorbidities are hypertension (32%), diabetes (32%), cardiovascular disease (24%), and kidney injury (12%), and the patients with gangrenes have the most comorbidities. As of May 10, 2020, there were 78 patients discharged, and their average stay time is 15.8 days (SD 14.2), while people still at the hospital is 39.7 days (SD 8.7) much longer than the discharged and also has more comorbidities. But there is no significant difference in the hospitalization time of three types of wounds. And fortunately, none of all the patients were infected by coronavirus.
The majority of patients with chronic wounds are severely ill with high risk of infection and poor prognosis; therefore, management of patients with chronic wounds should be improved.
2019 年底，中国湖北省出现了大量由新型β冠状病毒引起的肺炎病例，且具有很强的传播潜力。目前，已知的独立危险因素包括年龄、糖尿病和其他慢性疾病，这可能与慢性伤口患者相似；因此，我们试图探讨 COVID-19 流行期间慢性感染性伤口患者的临床特征、预后因素和管理建议。
本单中心回顾性观察性研究纳入了 2020 年 1 月 23 日中国 COVID-19 全面爆发至 2020 年 4 月 20 日前最后一天来我院就诊的所有慢性感染性伤口患者。收集所有患者的人口统计学数据、合并症、实验室和影像学检查结果、会诊史以及截至 2020 年 5 月 10 日的临床结局（治愈、未控制、截肢等）。根据伤口原因，将患者分为坏疽、创伤性感染和其他类型的软组织感染伤口（包括褥疮、痛风破裂、刺伤等），并对每组的疾病相关信息进行比较。
在 81 例慢性感染性伤口患者中，60%为男性，平均年龄为 60.8 岁（标准差 18.6），其中 38 例（47%）为创伤性感染，29 例（36%）为坏疽病例，14 例（17%）为其他软组织感染伤口。常见的合并症包括高血压（32%）、糖尿病（32%）、心血管疾病（24%）和肾脏损伤（12%），且坏疽患者的合并症最多。截至 2020 年 5 月 10 日，78 例患者出院，平均住院时间为 15.8 天（标准差 14.2），而仍在院患者的住院时间为 39.7 天（标准差 8.7），明显长于出院患者，且合并症更多。但三种类型的伤口的住院时间没有显著差异。幸运的是，所有患者均未感染冠状病毒。
大多数慢性伤口患者病情严重，感染风险高，预后差；因此，应加强对慢性伤口患者的管理。
