Harvard Medical School, Boston, MA, USA.
Department of Plastic Surgery, Rhode Island Hospital, Alpert Medical School of Brown University, Providence, RI, USA.
Wound Repair Regen. 2022 Mar;30(2):156-171. doi: 10.1111/wrr.12994. Epub 2022 Feb 7.
The Wound Healing Foundation (WHF) recognised a need for an unbiased consensus on the best treatment of chronic wounds. A panel of 13 experts were invited to a virtual meeting which took place on 27 March 2021. The proceedings were organised in the sub-sections diagnosis, debridement, infection control, dressings, grafting, pain management, oxygen treatment, outcomes and future needs. Eighty percent or better concurrence among the panellists was considered a consensus. A large number of critical questions were discussed and agreed upon. Important takeaways included that wound care needs to be simplified to a point that it can be delivered by the patient or the patient's family. Another one was that telemonitoring, which has proved very useful during the COVID-19 pandemic, can help reduce the frequency of interventions by a visiting nurse or a wound care center. Defining patient expectations is critical to designing a successful treatment. Patient outcomes might include wound specific outcomes such as time to heal, wound size reduction, as well as improvement in quality of life. For those patients with expectations of healing, an aggressive approach to achieve that goal is recommended. When healing is not an expectation, such as in patients receiving palliative wound care, outcomes might include pain reduction, exudate management, odour management and/or other quality of life benefits to wound care.
创面愈合基金会(WHF)认识到需要就慢性创面的最佳治疗方法达成无偏见的共识。邀请了 13 名专家组成专家组,于 2021 年 3 月 27 日举行了一次虚拟会议。会议内容分为诊断、清创、感染控制、敷料、植皮、疼痛管理、氧疗、结果和未来需求等部分。专家组 80%或更高的一致性被认为是达成共识。会上讨论并同意了大量的关键性问题。重要的结论包括,创面护理需要简化到患者或其家属可以自行进行的程度。另一个结论是,在 COVID-19 大流行期间已被证明非常有用的远程监测,可以帮助减少访视护士或创面护理中心干预的频率。明确患者的预期对于设计成功的治疗方案至关重要。患者的治疗结果可能包括创面特定的结果,如愈合时间、创面缩小以及生活质量的改善。对于那些期待创面愈合的患者,建议采取积极的方法来实现这一目标。对于那些不期待愈合的患者,如接受姑息性创面护理的患者,治疗结果可能包括疼痛减轻、渗出物管理、气味管理和/或其他对创面护理有益的生活质量改善。