Abstract:
Background Chronic cutaneous wounds seriously affect the patients’ life quality. In recent years, a special wound repair center has been set up in the Strategic Support Force Medical Center, but clinical epidemiological analysis has not been carried out.
Objective To analyze the clinical epidemiological characteristics of inpatients with chronic cutaneous wounds.
Methods A retrospective analysis was conducted on 889 patients with chronic cutaneous wounds admitted to the Strategic Support Force Medical Center from January 1, 2015 to December 31, 2020 to analyze its epidemiological characteristics.
Results Of the 889 patients, there were 599 males and 290 females, with the male to female ratio of 2.1:1. The median age was 64 years (range: 13 to 93 years). The occupational distribution was different in different age groups. In the age group of 21-60 years, more than half of the patients were manual workers, and in the age group over 60 years, nearly half of the patients were retired. The age group of 41-60 years had the highest prevalence rate of bad smoking habit. The prevalence of comorbidities such as hypertension, diabetes, heart disease and hyperlipidemia increased with age. Among them, 90.6% (444/490) of the patients aged from 61 to 80 years had diabetes. Diabetes mellitus (52.5%) was the main cause of chronic cutaneous wounds, followed by arterial wounds (37.6%). There were 419 cases (47.1%) examined for wound pathology, and the positive rate of pathogen was 77.3% (324/419). Of the 207 Gram-positive bacteria cases, there were 158 Gram-negative bacteria cases and 10 fungi cases. Surgical debridement combined with negative pressure suction and new dressings were the main treatment methods for most chronic wounds. Some cases received conservative treatment such as general dressing change combined with anti-inflammatory and circulation promotion, and some wounds were treated with growth factor, PRP, hyperbaric oxygen and infrared irradiation. Of the 889 cases, 110 cases (12.4%) were cured, 624 cases (70.2%) were improved, 148 cases (16.6%) deteriorated, and 7 cases (0.8%) died of cardiopulmonary failure caused by infection. There were 749 patients hospitalized once, accounting for 84.3%; while the rest 140 cases (15.7%) were hospitalized at least twice, including 104 cases for twice, 25 cases for 3 times, 6 cases for 4 times, 3 cases for 5 times, and 2 cases for 6 times. With the increase of hospitalization times, the average length of stay did not change significantly, but the average hospitalization costs decreased.
Conclusion Chronic cutaneous wounds mainly occurs in the middle-aged and senior people, with more male than female. Diabetic wounds and arterial wounds are the main causes of the disease. The main treatment of this disease is surgery, with high amputation rate. It has a high recurrence rate, leading to repeated hospitalization in some patients. With the increase of hospitalization times, the average length of stay does not change significantly, but the average hospitalization costs decrease.