Erfurt-Berge Cornelia, Michler Melanie, Renner Regina
Wundzentrum DDG/ICW, Hautklinik Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Ulmenweg 18, 91054, Erlangen, Deutschland.
Zentralbereich Medizin: Struktur‑, Prozess- und Qualitätsmanagement, Universitätsklinikum Tübingen, Hoppe-Seyler-Str. 6, 72076, Tübingen, Deutschland.
Hautarzt. 2021 Jun;72(6):517-524. doi: 10.1007/s00105-021-04759-8. Epub 2021 Jan 28.
Health care for patients with chronic wounds is often protracted. This can result in decreased quality of care or delayed diagnosis of the actual cause of disease. Concurrently, there are already certified facilities for these patients. The present work investigates possible reasons for delayed referral and whether a specific selection of patients is sent to these university-based centres.
A retrospective patient data chart review at the point of first admission to the certified wound centre was performed to identify concerning variables about the standard of care before university presentation.
Records of 177 patients were analysed (53% women, 47% men; patient age range 27-95 years). The mean duration of the wound was 22 months. Vascular diagnostics had already been performed in 32% (arterial diagnostics) and 36% (phlebological diagnostics), respectively. A tissue sample had been analysed in 9% of cases, especially when wound duration exceeded > 24 months. In only 45% of cases was the external diagnosis in accord with the final diagnosis in the wound centre.
The health care situation for patients with chronic wounds outside of specialised care structures is insufficient. Early and standardized diagnostics and therapy and a reasonable admission to specialised centres is desired.
慢性伤口患者的医疗护理往往旷日持久。这可能导致护理质量下降或对疾病实际病因的诊断延迟。与此同时,已有针对这些患者的认证机构。本研究调查转诊延迟的可能原因,以及是否有特定类型的患者被送往这些大学附属医院中心。
在首次入住认证伤口中心时,对患者数据图表进行回顾性分析,以确定在转诊至大学附属医院之前护理标准方面的相关变量。
分析了177例患者的记录(53%为女性,47%为男性;患者年龄范围27 - 95岁)。伤口的平均持续时间为22个月。分别有32%(动脉诊断)和36%(静脉诊断)的患者已经进行了血管诊断。9%的病例进行了组织样本分析,尤其是当伤口持续时间超过24个月时。仅45%的病例外部诊断与伤口中心的最终诊断一致。
在专门护理机构之外,慢性伤口患者的医疗护理状况不佳。需要早期、标准化的诊断和治疗,以及合理转诊至专门中心。