Chronic wounds: Treatment consensus

被引:173
作者
Eriksson, Elof [1 ]
Liu, Paul Y. [2 ]
Schultz, Gregory S. [3 ,4 ]
Martins-Green, Manuela M. [5 ]
Tanaka, Rica [6 ]
Weir, Dot [7 ]
Gould, Lisa J. [8 ]
Armstrong, David G. [9 ]
Gibbons, Gary W. [10 ]
Wolcott, Randy [11 ]
Olutoye, Oluyinka O. [12 ,13 ]
Kirsner, Robert S. [14 ]
Gurtner, Geoffrey C. [15 ]
机构
[1] Harvard Med Sch, Boston, MA 02115 USA
[2] Brown Univ, Rhode Isl Hosp, Alpert Med Sch, Dept Plast Surg, Providence, RI 02903 USA
[3] Univ Florida, Dept Obstet & Gynecol, Gainesville, FL 32611 USA
[4] Univ Florida, Inst Wound Res, Gainesville, FL USA
[5] Univ Calif Riverside, Dept Mol Cell & Syst Biol, Lab Wound Healing Biol, Riverside, CA 92521 USA
[6] Juntendo Univ, Sch Med, Tokyo, Japan
[7] Saratoga Hosp, Ctr Wound Healing & Hyperbar Med, Saratoga Springs, NY USA
[8] South Shore Hosp, Dept Surg, South Weymouth, MA USA
[9] Univ Southern Calif, Keck Sch Med, Los Angeles, CA 90007 USA
[10] Boston Univ, Ctr Wound Healing South Shore Hlth, Sch Med, Weymouth, MA USA
[11] Southwest Reg WCC, Lubbock, TX USA
[12] Nationwide Childrens Hosp, Ctr Regenerat Med, Abigail Wexner Res Inst, Columbus, OH USA
[13] Ohio State Univ, Dept Surg, Columbus, OH 43210 USA
[14] Univ Miami, Miller Sch Med, Dr Philip Frost Dept Dermatol & Cutaneous Surg, Miami, FL 33136 USA
[15] Stanford Univ, Sch Med, Palo Alto, CA 94304 USA
关键词
arterial; chronic; pressure; treatment consensus; venous; wounds; HYPERBARIC-OXYGEN THERAPY; DIABETIC FOOT ULCERS; QUALITY-OF-LIFE; VENOUS LEG ULCERS; CLINICAL-OUTCOMES; SKIN-GRAFTS; DEBRIDEMENT; MECHANISMS; GUIDELINES; MANAGEMENT;
D O I
10.1111/wrr.12994
中图分类号
Q2 [细胞生物学];
学科分类号
071009 ; 090102 ;
摘要
The Wound Healing Foundation (WHF) recognised a need for an unbiased consensus on the best treatment of chronic wounds. A panel of 13 experts were invited to a virtual meeting which took place on 27 March 2021. The proceedings were organised in the sub-sections diagnosis, debridement, infection control, dressings, grafting, pain management, oxygen treatment, outcomes and future needs. Eighty percent or better concurrence among the panellists was considered a consensus. A large number of critical questions were discussed and agreed upon. Important takeaways included that wound care needs to be simplified to a point that it can be delivered by the patient or the patient's family. Another one was that telemonitoring, which has proved very useful during the COVID-19 pandemic, can help reduce the frequency of interventions by a visiting nurse or a wound care center. Defining patient expectations is critical to designing a successful treatment. Patient outcomes might include wound specific outcomes such as time to heal, wound size reduction, as well as improvement in quality of life. For those patients with expectations of healing, an aggressive approach to achieve that goal is recommended. When healing is not an expectation, such as in patients receiving palliative wound care, outcomes might include pain reduction, exudate management, odour management and/or other quality of life benefits to wound care.
引用
收藏
页码:156 / 171
页数:16
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