Palomar-Albert David, Zamora-Ortiz Jorge, Palomar-Llatas Federico, Escudero-Martínez Marta, Naranjo-Cuellar Alba, Pastor-Orduña Maria Isabel
Integrity and Skin Care, Integrity and Skin Care Research Group, Catholic University of Valencia SanVicente Mártir, 46001 Valencia, Spain.
Ulcers Unit, Valencia General Hospital Department, 46014 Valencia, Spain.
Medicina (Kaunas). 2025 May 17;61(5):907. doi: 10.3390/medicina61050907.
: Chronic wounds severely impair patients' quality of life (QoL), impacting physical, emotional, and functional well-being. Understanding the multidimensional effects of treatment is key to implementing effective, patient-centered care strategies. This study aimed to assess changes in QoL among patients with chronic wounds using the Dermatology Life Quality Index (DLQI) and EuroQol-5D (EQ-5D), comparing outcomes across treatment modalities. : A longitudinal observational study was conducted between 2019 and 2024 across three hospitals in the Valencian Community. A total of 278 patients with venous lower-limb ulcers of more than six weeks' duration were included. Quality-of-life assessments were performed at baseline, one-month follow-up, and discharge. Treatments included alginate, foam, moist wound healing (MWH), compression therapy, and negative-pressure wound therapy (NPWT). Statistical analysis involved Friedman's test and repeated-measures ANOVA. : Significant improvements were observed in overall QoL across most treatment modalities. EQ-5D scores progressively increased, while DLQI scores decreased. Pain, embarrassment, and limitations in daily life (e.g., shopping and social activities) showed marked reductions. MWH and foam demonstrated the most favorable impact on QoL, while NPWT showed more modest improvements, possibly due to patient complexity. Notably, the variable "sexuality" remained unchanged (mean = 0.00), possibly due to underreporting or communication barriers. : Chronic wound treatments significantly improve patients' quality of life, particularly in terms of pain and social functioning. The use of combined tools (DLQI and EQ-5D) allows for a more comprehensive understanding of these outcomes. These findings highlight the importance of tailoring wound care to individual needs and addressing psychosocial domains, including sexuality. Community nursing, nutritional support, and long-term follow-up should be incorporated into care plans to optimize results, especially in older adults.
慢性伤口严重损害患者的生活质量（QoL），影响身体、情感和功能健康。了解治疗的多维度效果是实施有效、以患者为中心的护理策略的关键。本研究旨在使用皮肤病生活质量指数（DLQI）和欧洲五维健康量表（EQ-5D）评估慢性伤口患者的生活质量变化，比较不同治疗方式的结果。
2019年至2024年期间在巴伦西亚自治区的三家医院进行了一项纵向观察性研究。共纳入278例病程超过六周的下肢静脉溃疡患者。在基线、1个月随访和出院时进行生活质量评估。治疗方法包括藻酸盐、泡沫敷料、湿性伤口愈合（MWH）、加压治疗和负压伤口治疗（NPWT）。统计分析采用弗里德曼检验和重复测量方差分析。
在大多数治疗方式中，总体生活质量均有显著改善。EQ-5D评分逐渐升高，而DLQI评分降低。疼痛、尴尬以及日常生活中的限制（如购物和社交活动）明显减少。MWH和泡沫敷料对生活质量的影响最为显著，而NPWT的改善较为有限，可能是由于患者情况复杂所致。值得注意的是，“性方面”这一变量保持不变（均值 = 0.00），可能是由于报告不足或沟通障碍。
慢性伤口治疗显著改善了患者的生活质量，尤其是在疼痛和社会功能方面。联合使用工具（DLQI和EQ-5D）能够更全面地了解这些结果。这些发现凸显了根据个体需求定制伤口护理以及关注包括性方面在内的心理社会领域的重要性。社区护理、营养支持和长期随访应纳入护理计划以优化结果，尤其是在老年人中。
