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——??關(guān)于慢性傷口??——
——??關(guān)于慢性傷口??——
副標(biāo)題
慢性創(chuàng)面已成為我國(guó)體表創(chuàng)面的主要形式
● 病因復(fù)雜，往往由各種慢性病引起
● 老年患者居多，嚴(yán)重影響患者晚年生活質(zhì)量
● 患者家庭負(fù)擔(dān)大：治療周期長(zhǎng)、愈合難，親屬看護(hù)壓力大
我國(guó)每年有3000萬(wàn)慢性難愈合創(chuàng)面。
我國(guó)糖尿病患者1.14億。
糖尿病足潰瘍是糖尿病常
見的并發(fā)癥之一。預(yù)計(jì)
15-20%的糖尿病患者
最終會(huì)患糖尿病足潰瘍。
大部分慢性創(chuàng)面患者會(huì)前
往醫(yī)院就診。但是有約
20-30%的慢性創(chuàng)面患
者會(huì)長(zhǎng)期居家臥床。這其
中以農(nóng)村空巢老人的壓瘡
問題最為嚴(yán)重。
2018我國(guó)60歲以上老人
已達(dá)2.41億。
糖尿病足潰瘍
壓瘡
我國(guó)慢性創(chuàng)面患者分布：
900萬(wàn)
壓瘡
600萬(wàn)
糖尿病足
700萬(wàn)
感染性潰瘍
250萬(wàn)
血管性潰瘍
550萬(wàn)
其他
——??關(guān)于NPWT ?——
——??關(guān)于NPWT ?——
副標(biāo)題
以上文字摘自《EWMA DOCUMENT: NEGATIVE PRESSURE WOUND THERAPY OVERVIEW, CHALLENGES AND PERSPECTIVES（EWMA文檔 負(fù)壓傷口治療，回顧、挑戰(zhàn)及展望） 》2017年版。
European Wound Management Association(EWMA)，歐洲傷口管理協(xié)會(huì)。
NPWT至今已在全球治療服務(wù)患者超過(guò)1000萬(wàn)，對(duì)于各類急慢性傷口，由海內(nèi)外各傷口治療組織或
協(xié)會(huì)，發(fā)布了針對(duì)不同類型傷口的NPWT臨床論文超過(guò)3000份，包括得到廣受認(rèn)可的治療指南或共識(shí)文
獻(xiàn)等。NPWT治療各種急慢性傷口的療效及價(jià)值，在全球范圍內(nèi)已廣為認(rèn)可。
1 Bobkiewicz, A., Banasiewicz, T., Ledwosinski, W., Drews, M. Medical terminology associated with Negative Pressure
Wound Therapy (NPWT). Understanding and misunderstanding in the field of NPWT. Negative Pressure Wound
Therapy. 2014; 1: 2, 69–73.
2 Hampton, J. Providing cost-effective treatment of hard-to-heal wounds in the community through use of NPWT. Br J Community Nurs 2015; 20: Suppl 6, S14–S20.
2 Hampton, J. Providing cost-effective treatment of hard-to-heal wounds in the community through use of NPWT. Br J Community Nurs 2015; 20: Suppl 6, S14–S20.
3 Apelqvist, J., Armstrong, D.G., Lavery, L.A., Boulton, A.J. Resource utilization and economic costs of care based on a randomized trial of vacuum-assisted closure therapy in the treatment of diabetic foot wounds. Am J Surg 2008; 195: 6, 782–788.
4 Acosta, S., Bjarnason, T., Petersson, U. et al. Multicentre prospective study of fascial closure rate after open abdomen with vacuum and mesh-mediated fascial traction.
Br J Surg 2011; 98: 5, 735–743.
5 Kaplan, M. Negative pressure wound therapy in the management of abdominal compartment syndrome. Ostomy Wound Manage 2005; 51: 2A Suppl, 29S–35S.
6 Swan, M., Banwell, P. Topical negative pressure. Advanced management of the open abdomen. Oxford Wound Healing Society. 2003.
7 Fuchs, U., Zittermann, A., Stuettgen, B. et al. Clinical outcome of patients with deep sternal wound infection managed by vacuum-assisted closure compared to conventional therapy with open packing: a retrospective analysis. Ann Thorac Surg 2005; 79: 2, 526–531.
8 Fleck,T., Gustafsson, R., Harding, K. et al. The management of deep sternal wound infections using vacuum assisted closure? (V.A.C.?) therapy. Int Wound J 2006; 3: 4, 273–280.
9 Armstrong, D.G., Lavery, L.A., Diabetic Foot Study Consortium. Negative pressure wound therapy after partial diabetic foot amputation: a multicentre, randomised controlled trial. Lancet 2005; 366: 9498, 1704–1710.
10 Blume, P.A., Walters, J., Payne, W. et al. Comparison of negative pressure wound therapy using vacuum-assisted closure with advanced moist wound therapy in the treatment of diabetic foot ulcers: a multicenter randomized controlled trial. Diabetes Care 2008; 31:4, 631–636.
11 Trueman, P. Cost-effectiveness considerations for home health V.A.C. Therapy in the United States of America and its potential international application. Int Wound J. 2008; 5: Suppl 2, 23–26.
NPWT（Negative Pressure Wound Therapy 負(fù)壓傷口治療）是上世紀(jì)90年代以來(lái)發(fā)展起來(lái)的關(guān)于傷口治療的新技術(shù)。自被引入臨床實(shí)踐以來(lái)，負(fù)壓傷口治療已廣泛應(yīng)用于門診和住院中復(fù)雜傷口的管理*1。
NPWT被認(rèn)為是許多不同病因的傷口的有效治療方案*2,3，并被推薦作為治療創(chuàng)面的金標(biāo)準(zhǔn)-如開放式腹部傷口*4-6，心臟手術(shù)后的開裂胸骨傷口*7,8等，以及各種復(fù)雜難愈合創(chuàng)面*9,10中的有價(jià)值的治療方案。越來(lái)越多的NPWT被應(yīng)用在居家傷口管理中，其被認(rèn)為在提升傷口管理效果方面具有巨大潛力，有助于減少對(duì)醫(yī)院護(hù)理的依賴*11。