Zhonghua Shao Shang Yu Chuang Mian Xiu Fu Za Zhi. 2025 May 20;41(5):401-416. doi: 10.3760/cma.j.cn501225-20241128-00466.
Early prevention and standardized management of refractory wounds in the elderly are very important for improving prognosis, reducing disability rate, and improving the quality of life of patients. For the diagnosis and treatment of refractory wounds in the elderly, it is necessary to comprehensively consider the primary disease or comorbidity of patients and systematically evaluate the overall condition and the local characteristics of wounds of patients. The treatment principles include controlling or slowing down the development of the primary disease, nutritional support, infection control, improving circulation, sealing wounds, and paying attention to the water balance of wounds, at the same time selecting a reasonable treatment plan according to different types of wounds. The goal of treatment is to close the wound as much as possible if conditions permit, while in some cases, palliative management may be appropriate. In the future, the development of smart wear, big data, and artificial intelligence will play a significant role in promoting the assessment and treatment of refractory wounds in the elderly. The Burns and Trauma Branch of Chinese Geriatrics Society organized domestic experts engaged in wound repair and related fields to jointly formulate this consensus, aiming to establish a full-process standard covering prevention, assessment, treatment, and rehabilitation and to promote the standardization and intelligence of diagnosis and treatment of refractory wounds in the elderly, thus providing efficient and homogeneous solutions for clinical practice.
老年人难治性伤口的早期预防和规范化管理对于改善预后、降低致残率以及提高患者生活质量至关重要。对于老年人难治性伤口的诊治,有必要全面考虑患者的原发疾病或合并症,并系统评估患者的整体状况及伤口局部特点。治疗原则包括控制或减缓原发疾病的发展、营养支持、控制感染、改善循环、封闭伤口以及关注伤口的水平衡,同时根据不同类型的伤口选择合理的治疗方案。治疗目标是在条件允许的情况下尽可能闭合伤口,而在某些情况下,姑息治疗可能是合适的。未来,智能穿戴、大数据和人工智能的发展将在促进老年人难治性伤口的评估和治疗方面发挥重要作用。中华老年医学会烧伤与创伤分会组织国内从事伤口修复及相关领域的专家共同制定本共识,旨在建立涵盖预防、评估、治疗和康复的全过程标准,推动老年人难治性伤口诊治的规范化和智能化,从而为临床实践提供高效、同质化的解决方案。