Gruen R L, Chang S, MacLellan D G
Department of Surgery, University of Melbourne, Australia.
Aust N Z J Surg. 1996 Mar;66(3):171-4. doi: 10.1111/j.1445-2197.1996.tb01150.x.
Leg ulcers are common and are often the cause of a long hospital admission. However, little information is available on the efficacy and efficiency of inpatient leg ulcer management. The inpatient management of leg ulceration was examined and areas for improvement were sought.
The management of patients admitted to a teaching hospital with a primary diagnosis of leg ulceration was examined, the costs estimated and areas for improvement identified. A retrospective analysis of 174 admissions to Heidelberg Repatriation Hospital between 1 January 1991 and 31 December 1992 was performed.
Of 119 patients, 61 had ulcers due to arterial disease and 34 due to venous disease. Over 2 years, leg ulcers accounted for 5259 inpatient bed days, a mean of 44.2 days per patient. The estimated cost exceeded $2,750,000, averaging over $12,000 per admission. Thirty-three percent of patients had no recorded investigations into the cause of their ulcer and fewer than 50% had documented improvement at discharge.
Leg ulcers are costly due to their extended treatment on an inpatient basis. Unfortunately, hospital admission does not guarantee optimal wound healing rates. A leg ulcer protocol is proposed to minimize inpatient stay and improve investigation and management in an outpatient or community setting.
腿部溃疡很常见，常常是导致长期住院的原因。然而，关于住院患者腿部溃疡治疗的疗效和效率的信息却很少。对住院患者腿部溃疡的治疗进行了研究，并寻找改进的方面。
对一所教学医院收治的以腿部溃疡为主要诊断的患者的治疗情况进行了研究，估算了费用，并确定了改进的方面。对1991年1月1日至1992年12月31日期间海德堡遣返医院的174例住院病例进行了回顾性分析。
在119例患者中，61例溃疡由动脉疾病引起，34例由静脉疾病引起。在两年多的时间里，腿部溃疡占住院床位5259天，平均每位患者44.2天。估计费用超过275万美元，每次住院平均超过1.2万美元。33%的患者没有对溃疡病因进行记录调查，出院时记录有病情改善的患者不到50%。
由于腿部溃疡需要长期住院治疗，费用高昂。不幸的是，住院治疗并不能保证最佳的伤口愈合率。建议制定腿部溃疡治疗方案，以尽量缩短住院时间，并改善门诊或社区环境中的检查和治疗。
