是“慢性”,“創傷”,“成長”,“問題”嗎?

  • 慢性傷口是指通常在3個月內未能通過有序,及時的修復過程的傷口。
  • 傷口癒合協會(WHS)指出,慢性傷口影響著大約1%至2%的人口。
  • 隨著人們年齡的增長,傷口閉合變得更加困難。

Chronic wounds aren't something most people have to think about, although those that do know how difficult they can be.慢性傷口不是大多數人必須考慮的事情,儘管那些確實知道有多難的傷口也是如此。 With health complications on the rise, we must ask ourselves as healthcare professionals: are chronic wounds a growing problem in our world?隨著健康並發症的增加,我們必須以醫療保健專業人員的身份問自己:慢性傷口在我們世界上是否正在成為一個日益嚴重的問題?

It's estimated that about 6.5 million Americans suffer from a chronic, non-healing wound of some sort.據估計,大約有25萬美國人患有某種慢性,無法癒合的傷口。 The annual cost of treating chronic wounds in the US is estimated to be $XNUMX billion, signifying a huge, and potentially even growing, chronic wound care industry.在美國,每年治療慢性傷口的費用估計為XNUMX億美元,這標誌著一個巨大的,甚至可能在增長的慢性傷口護理行業。

傷口的癒合過程可能非常複雜,對於患有慢性疾病的患者甚至更是如此。

Chronic wounds are wounds which have failed to proceed through an orderly and timely reparative process, usually within a period of 3 months.慢性傷口是指通常在XNUMX個月內未能通過有序,及時的修復過程進行的傷口。 Chronic wounds are also those that have proceeded through the repair process without establishing a sustained, anatomic, and functional result.慢性傷口也是那些在修復過程中未建立持續,解剖和功能性結果的傷口。

傷口癒合協會(WHS)指出,慢性傷口影響了大約1%至2%的人口,該小組將慢性傷口分為以下四類:

  • 壓瘡
  • 糖尿病性潰瘍
  • 靜脈潰瘍
  • 動脈供血不足潰瘍

數字告訴我們什麼

Numbers like those referenced above reflect an increasingly large percentage of elderly people in the general population.上面提到的數字反映了老年人口在總人口中的比例越來越高。 As people age, wound closure becomes more difficult, and the decline of the overall health becomes more likely, further complicating wound closure.隨著人們的年齡增長,傷口閉合變得更加困難,並且整體健康狀況下降的可能性變得更大,這使得傷口閉合更加複雜。

研究發現 隨著年齡的增長和對慢性傷口的敏感性增加,生活質量也下降。 Specifically, health-related quality of life has been shown to be lowest for physical pathologies, especially for patients with chronic wounds and for those with wound-related amputations.具體而言,對於身體病理,與健康相關的生活質量已顯示出最低,尤其是對於具有慢性傷口的患者和與傷口相關的截肢患者而言。

慢性傷口還會對患者的心理健康產生重大影響,通常會導致抑鬱,羞恥,焦慮和社交孤立。 這些增加的壓力可能會擴展到患者的家庭,長期住院會導致經濟負擔,而應對長期護理也是如此。

In one example, the cost for leg amputation for a patient with comorbid diabetes ranged from $12,851 to $16,267.在一個示例中,患有合併症的糖尿病患者的腿截肢的費用在XNUMX美元至XNUMX美元之間。 Further, chronic wounds impose a significant and often underappreciated burden to the healthcare system and to society as a whole.此外,慢性傷口給醫療保健系統和整個社會帶來了很大的負擔,而且常常被人們忽視。

潛在因素

心血管疾病

The wound-healing process can be quite complex, and even more so for patients with chronic conditions.傷口的癒合過程可能非常複雜,對於患有慢性疾病的患者甚至更是如此。 Chronic diseases impede the body's natural ability to recover, and in the case of cardiovascular conditions, they also impair the flow of blood, oxygen, and nutrients to the wound site.慢性疾病會阻礙人體自然恢復的能力,在心血管疾病的情況下,它們也會損害血液,氧氣和營養物質流向傷口的位置。

糖尿病

糖尿病是另一種嚴重中斷傷口癒合的疾病。 It's estimated that close to 15 percent of those with diabetes also suffer from a chronic wound.據估計,近XNUMX%的糖尿病患者也患有慢性傷口。 Similar to cardiovascular disease, diabetes causes restricted blood flow to the wound.與心血管疾病相似,糖尿病會導致傷口的血流受限。 High glucose levels can also restrict blood vessels and stiffen arteries, increasing the likelihood of chronic wounds.高葡萄糖水平還可以限制血管和硬化動脈,增加慢性傷口的可能性。 As one expert notes about diabetic wounds, “A small foot blister can quickly become a chronic open sore.正如一位專家指出的那樣,糖尿病傷口是:“小足皰會很快變成慢性開放性瘡。 Without early intervention and effective treatment, the patient may be at risk of amputation.”沒有早期干預和有效治療,患者可能有截肢的危險。”

循環薄弱

People with poor circulation – for instance, as a result of peripheral artery disease (PAD) – also have difficulty supplying enough oxygen to the wound site to promote healing.例如,由於外周動脈疾病(PAD)導致血液循環不良的人也難以向傷口部位提供足夠的氧氣以促進癒合。 Similarly, venous insufficiency, which causes the veins to become enlarged and varicose, can also increase the likelihood of developing wounds on the lower legs or feet.同樣,靜脈功能不全會導致靜脈變大和曲張,也可能增加小腿或小腳上出現傷口的可能性。 As blood collects in the legs, pressure makes blood circulation more difficult, and the result is that not enough oxygen is available to由於血液聚集在腿部,壓力使血液循環更加困難,結果是沒有足夠的氧氣可用於 促進傷口癒合.

自身免疫

Another underlying factor that can contribute to poor wound healing is a weakened immune system, or autoimmunity.可能導致傷口癒合不良的另一個潛在因素是免疫系統減弱或自身免疫。 This can occur from diseases like cancer, liver, or kidney disease, or due to poor nutrient status.這可能是由於癌症,肝癌或腎病等疾病引起的,也可能是由於營養狀況不佳引起的。

床或輪椅禁閉

局限於床或輪椅上的人可能會因自身體重對身體某些部位施加恆定壓力而患上褥瘡(褥瘡)。

研究發現,隨著年齡的增長和對慢性傷口的敏感性增加,生活質量也會下降。

慢性傷口怎麼辦?

對於有慢性傷口的人 治療通常旨在治療基礎疾病以及傷口本身。 For those with diabetes, for example, blood sugar levels need to be regulated so the wound can heal normally.例如,對於糖尿病患者,需要調節血糖水平,以便傷口能夠正常the愈。 For those with a weakened immune system, nutritional status and diet should be addressed to improve the immune system and the body's ability to heal.對於那些免疫系統較弱的人,應注意營養狀況和飲食,以改善免疫系統和人體的康復能力。 Venous insufficiency is often treated with compression stockings or compression bandages (tight elastic bandages) to improve blood circulation, making it easier for existing wounds to heal.靜脈功能不全通常用加壓襪或加壓繃帶(緊繃繃帶)治療,以改善血液循環,使現有傷口更容易癒合。

慢性傷口的治療涉及到時間原則的應用。

  • 組織清創
  • 感染控制
  • 水分平衡
  • 傷口邊緣

Before debridement, the wound must be cleaned fully with a saline or electrolyte solution.清創術前,必須用生理鹽水或電解質溶液徹底清洗傷口。 Following this, dead cells or inflamed tissue can be carefully removed with tweezers or a scalpel.之後,可以用鑷子或手術刀小心地清除死細胞或發炎的組織。 This can also be achieved through surgical or autolytic/enzymatic mechanisms.這也可以通過外科或自溶/酶促機制來實現。 The goal of debridement is to expose healthy, well-perfused tissue that is able to proliferate and populate the wound bed.清創術的目的是暴露健康的,灌注良好的組織,該組織能夠擴散並遍布傷口床。

As debridement can be painful, a topical anesthetic such as a medicated ointment can be applied to the wound area to prevent pain.由於清創術可能很痛苦,因此可以在傷口區域使用局部麻醉藥(例如藥膏)以防止疼痛。 When pain is severe, medication can also be taken before debridement.當疼痛嚴重時,也可以在清創前服用藥物。

Wound dressings are typically employed to control infection.傷口敷料通常用於控制感染。 For example, a moist occlusive dressing helps support the inflammatory phase of healing by creating an environment with enough oxygen to promote wound healing.例如,潮濕的閉塞敷料可通過創建一個具有足夠氧氣以促進傷口癒合的環境來幫助支持癒合的炎症階段。 When bacteria or persistent infection is present, antibiotics can be used to further prevent and control infection.當存在細菌或持續感染時,可以使用抗生素進一步預防和控制感染。

Keeping the wound moist is often achieved through the use of hydrocolloids and hydrogels which are hydrophilic and promote a moist environment.通常通過使用親水且促進潮濕環境的水膠體和水凝膠來保持傷口濕潤。 Wound dressings and bandages can also help maintain moisture balance and prevent dryness from impairing wound healing.傷口敷料和繃帶還可以幫助保持水分平衡,並防止乾燥損害傷口癒合。

Promoting wound closure, or attending to the edges of the wound, involves the use of negative pressure wound therapy, or vacuum-assisted closure.促進傷口閉合或護理傷口邊緣涉及使用負壓傷口療法或真空輔助閉合。 By maintaining a moist environment, optimizing blood flow, removing exudates, and applying pressure to promote wound closure, vacuum-assisted closure or negative pressure treatment has shown a high degree of efficacy in treating chronic wounds.通過維持濕潤的環境,優化血液流動,去除滲出液並施加壓力以促進傷口閉合,真空輔助閉合或負壓治療已顯示出在治療慢性傷口方面的高度功效。

在受傷的世界中照顧慢性傷口

With seniors representing a large percentage of the population and increasing rates of diabetes, heart disease, and immunity impairment, chronic wounds are considered a growing problem.由於老年人佔人口的很大比例,並且糖尿病,心髒病和免疫力受損的比率不斷增加,慢性傷口被認為是一個日益嚴重的問題。 While that may seem intimidating, it doesn't have to be.雖然這看起來令人生畏,但不一定如此。 Through understanding and treatment of underlying conditions, and by employing techniques to treat chronic wounds, patient outcomes can be dramatically improved, and together we can make chronic wound care as painless as possible.通過了解和治療潛在疾病,並採用治療慢性傷口的技術,可以顯著改善患者的治療效果,並且我們可以使慢性傷口護理盡可能地減輕痛苦。

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格莫里斯

Gayle Morris is a freelance writer that's been writing on health and wellness for over ten years.蓋爾·莫里斯(Gayle Morris)是一位自由撰稿人,他從事健康方面的研究已有十多年了。 She spent over 20 years as a certified nurse and nurse practitioner before hanging up her stethoscope and picking up the pen.0在掛起聽診器並拿起筆之前,她在註冊護士和護士執業醫師上工作了XNUMX多年。XNUMX

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