Snyder Robert J, Driver Vickie, Cole Windy, Joseph Warren S, Reyzelman Alez, Lantis Ii John C, Kaufman Jarrod, Wild Thomas
Dean, School of Podiatric Medicine and Professor and Director of Clinical Research, Barry University School of Podiatric Medicine, Miami, FL.
System Chief, Wound Care, Limb Preservation and Hyperbaric Medicine Centers and Director, Wound Care and Hyperbaric Research, Inova Heart and Vascular Institute, Inova Healthcare System, and Professor at the University of Virginia, School of Medicine, Alexandria, VA.
Wounds. 2023 Jan;35(1):2-8. doi: 10.25270/wnds/22061.
The etiology of acute and chronic wounds goes beyond those often reported in the literature, including those with exposed structures, those in which the entire wound bed cannot be visualized, and patients who are not candidates for typical standard of care. Treatment options for these patients may be limited. TABCT is a viable option for these complex wound types and is not hindered by logistical, procedural, or patient factors. A consensus panel of providers with extensive experience in treatment of these wound types was convened to develop consensus recommendations on the use of TABCT in specific complex wound types. Four consensus statements were defined for TABCT use in patients who cannot undergo sharp or extensive debridement, as a protective barrier to prevent further bacterial ingress, in patients with wounds in which the entire wound bed cannot be safely visualized, and in wounds with exposed tendon and/or bone. Consensus panel recommendations show that TABCT application assists in maintenance of a moist wound healing environment, autolytic debridement, recruitment and delivery of factors essential for wound healing, prevention of pathogen entry, and ability to completely fill wound voids that cannot be fully visualized. Additional advantages of TABCT use are its cost-effectiveness, ease of access, minimal related complications, and proven clinical efficacy.
急慢性伤口的病因超出了文献中经常报道的范围，包括有外露结构的伤口、无法看清整个伤口床的伤口以及不符合典型标准护理条件的患者。这些患者的治疗选择可能有限。对于这些复杂伤口类型，组织粘合剂桥接封闭疗法（TABCT）是一种可行的选择，并且不受后勤、操作或患者因素的阻碍。召集了一个由在治疗这些伤口类型方面具有丰富经验的医疗服务提供者组成的共识小组，以就TABCT在特定复杂伤口类型中的使用制定共识建议。针对不能进行锐性或广泛清创的患者、作为防止细菌进一步侵入的保护屏障、针对伤口床无法安全看清的患者以及有外露肌腱和/或骨骼的伤口，定义了四项关于使用TABCT的共识声明。共识小组的建议表明，应用TABCT有助于维持湿润的伤口愈合环境、自溶性清创、募集和输送伤口愈合所需的因子、防止病原体进入以及完全填充无法完全看清的伤口空隙的能力。使用TABCT的其他优点包括其成本效益、易于获取、相关并发症极少以及已证实的临床疗效。
