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成人复杂性创伤愈合延迟的预后因素:范围综述。

Prognostic factors for delayed healing of complex wounds in adults: A scoping review.

机构信息

Centre for Interdisciplinary Research in Health, Instituto de Ciências da Saúde, Universidade Católica Portuguesa, Porto, Portugal.

School of Nursing Department, Universidade Federal Ceará, Fortaleza, Brazil.

出版信息

Int Wound J. 2023 Sep;20(7):2869-2886. doi: 10.1111/iwj.14128. Epub 2023 Mar 14.

Abstract

Complex or hard-to-heal wounds continue to be a challenge because of the negative impact they have on patients, caregivers, and all the associated costs. This study aimed to identify prognostic factors for the delayed healing of complex wounds. Five databases and grey literature were the sources used to research adults with pressure ulcers/injuries, venous leg ulcers, critical limb-threatening ischaemia, or diabetic foot ulcers and report the prognostic factors for delayed healing in all care settings. In the last 5 years, a total of 42 original peer-reviewed articles were deemed eligible for this scoping review that followed the JBI recommendations and checklist PRISMA-ScR. The most frequent prognostic factors found with statistical significance coinciding with various wound aetiologies were: gender (male), renal disease, diabetes, peripheral arterial disease, the decline in activities of daily life, wound duration, wound area, wound location, high-stage WIfI classification, gangrene, infection, previous ulcers, and low ankle brachial index. It will be essential to apply critical appraisal tools and assessment risk of bias to the included studies, making it possible to make recommendations for clinical practice and build prognostic models. Future studies are recommended because the potential for healing through identification of prognostic factors can be determined, thus allowing an appropriate therapeutic plan to be developed.

摘要

复杂或难以愈合的伤口仍然是一个挑战,因为它们会对患者、护理人员以及所有相关费用产生负面影响。本研究旨在确定复杂伤口愈合延迟的预后因素。本研究使用了五个数据库和灰色文献,对患有压力性溃疡/损伤、静脉下肢溃疡、肢体严重缺血性疾病或糖尿病足溃疡的成年人进行研究,并报告所有护理环境中延迟愈合的预后因素。在过去的 5 年中,共有 42 篇符合条件的原始同行评审文章被认为符合 JBI 建议和 PRISMA-ScR 清单。与各种伤口病因相关的具有统计学意义的最常见预后因素包括:性别(男性)、肾脏疾病、糖尿病、外周动脉疾病、日常生活活动能力下降、伤口持续时间、伤口面积、伤口位置、WIfI 分级高、坏疽、感染、既往溃疡和低踝肱指数。应用关键评估工具和评估偏倚风险对纳入的研究进行评估至关重要,从而有可能为临床实践提供建议并建立预后模型。建议开展未来的研究,因为可以通过识别预后因素来确定愈合的潜力,从而制定适当的治疗计划。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3509/10410354/7d53774e4aa7/IWJ-20-2869-g001.jpg

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