Application of multi-disciplinary team model led by enterostomal therapist in the diagnosis and treatment of chronic wounds_West China Medical Journal

Authors：

SHI Yulan , YU Jingya , XIANG Lijuan , CHEN Cheng , LI Lu ,  DAI Yan ,  ZHAO Shuzhen

Outpatient Department, West China Hospital, Sichuan University / West China School of Nursing, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

DAI Yan, Email: 1846703501@qq.com; ZHAO Shuzhen, Email: sssZsZZsz@126.com

Keywords：

Enterostomal therapist; multi-disciplinary team; chronic wound; effect

DOI：

10.7507/1002-0179.202304084

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To explore the clinical practice effects of multi-disciplinary team (MDT) model led by enterostomal therapist in the diagnosis and treatment of chronic wounds. Methods Three types of subspecialty patients diagnosed and treated by the MDT team for chronic wounds in the Wound Care Center of West China Hospital of Sichuan University between January 2020 and December 2022, including MDT for diabetes feet, MDT for immune ulcer and MDT for other refractory wounds, were retrospectively included. The clinical data, healing rate, healing time, and satisfaction rate of patients were analyzed. Results A total of 176 patients were included, including 103 cases of diabetes foot, 31 cases of immune ulcer, and 42 cases of other refractory wounds. The healing rate was 71.84% in patients with MDT of diabetes foot, 74.19% in patients with MDT of immune ulcer and 78.57% in patients with MDT of other refractory wound. The average healing time was 18.10 weeks for patients with diabetes foot, 19.69 weeks for patients with immune ulcer, and 20.53 weeks for patients with other refractory wounds. The satisfaction rates of patients in the three groups were relatively high (>95%). Conclusion The MDT model led by enterostomal therapist can provide comprehensive treatment plans for difficult and complex chronic wound patients, improve the treatment outcomes of chronic wounds, and is worthy of further promotion and application in the clinical diagnosis and treatment of chronic wounds.

Citation： SHI Yulan, YU Jingya, XIANG Lijuan, CHEN Cheng, LI Lu, DAI Yan, ZHAO Shuzhen. Application of multi-disciplinary team model led by enterostomal therapist in the diagnosis and treatment of chronic wounds. West China Medical Journal, 2024, 39(1): 17-21. doi: 10.7507/1002-0179.202304084 Copy

1.	Nussbaum SR, Carter MJ, Fife CE, et al. An economic evaluation of the impact, cost, and medicare policy implications of chronic nonhealing wounds. Value Health, 2018, 21(1): 27-32.
2.	冉兴无, 许樟荣. 以创新促发展, 应对日益增多的难治性糖尿病足溃疡. 四川大学学报(医学版), 2022, 53(6): 945-948.
3.	张纪蔚, 张柏根. 下肢难治性静脉溃疡. 中国实用外科杂志, 2001, 21(5): 269-271.
4.	封红伟, 陈丽琴, 胡绣华, 等. 专科护士为主导多学科慢性伤口护理团队的建立与实践. 国际护理学杂志, 2020, 39(13): 2312-2315.
5.	Garcia AN, Costa LDCM, Hancock MJ, et al. McKenzie method of mechanical diagnosis and therapy was slightly more effective than placebo for pain, but not for disability, in patients with chronic non-specific low back pain: a randomised placebo controlled trial with short and longer term follow-up. Br J Sports Med, 2018, 52(9): 594-600.
6.	张海滨, 史海娜, 王旭东. MDT 诊疗模式救治急诊危重批量伤患者的临床应用. 中国急救复苏与灾害医学杂志, 2018, 13(3): 231-233.
7.	杨爱花, 严梅, 秦亚辉. 国内外造口专科护理发展现状. 护理研究, 2016(1): 4-7.
8.	魏在荣, 黄广涛. 慢性创面的治疗进展及创面外科整合治疗模式探讨. 中华烧伤杂志, 2019, 35(11): 824-827.
9.	吴弟群, 罗孟媛, 陈旭, 等. 多学科合作对人工气道患者肺部感染发生率的影响研究. 齐鲁护理杂志, 2019, 25(19): 51-53.
10.	魏群英, 罗彩红, 窦梦. 多学科团队协作模式在急性脑外伤手术患者中的应用. 齐鲁护理杂志, 2021, 27(4): 80-82.
11.	马辉. 造口治疗师(ET)在多学科协作治疗(MDT)中的临床实践进展. 结直肠肛门外科, 2020, 26(2): 247-250.
12.	冯玉婕, 陈麒麟, 封秀萍, 等. 专职护理人员在提升多学科综合门诊诊疗服务中的作用. 齐鲁护理杂志, 2021, 27(7): 88-90.
13.	Albright RH, Manohar NB, Murillo JF, et al. Effectiveness of multidisciplinary care teams in reducing major amputation rate in adults with diabetes: a systematic review & meta-analysis. Diabetes Res Clin Pract, 2020, 161: 107996.
14.	Joret MO, Osman K, Dean A, et al. Multidisciplinary clinics reduce treatment costs and improve patient outcomes in diabetic foot disease. J Vasc Surg, 2019, 70(3): 806-814.
15.	蒋琪霞, 周济宏, 钱洪波, 等. 跨学科团队合作处理复杂伤口的实践与效果. 中国护理管理, 2018, 18(1): 10-14.
16.	Fournier C, Singbo N, Morissette N, et al. Outcomes of diabetic foot ulcers in a tertiary referral interdisciplinary clinic: a retrospective canadian study. Can J Diabetes, 2021, 45(3): 255-260.
17.	Shanmugam VK, Angra D, Rahimi H, et al. Vasculitic and autoimmune wounds. J Vasc Surg Venous Lymphat Disord, 2017, 5(2): 280-292.
18.	吴莉萍, 张子云, 娄雪娇, 等. 风湿免疫疾病患者皮肤溃疡的多学科协作综合护理. 护理学杂志, 2022, 37(16): 38-40.
19.	余瑾, 黄站梅, 吴锐, 等. 威伐光促进免疫性溃疡愈合的护理研究. 中国当代医药, 2020, 27(33): 204-206,214.
20.	孙红, 黄汉伟, 曾茹英, 等. 慢性伤口治疗护理团队合作模式的建立与效果评价. 海南医学, 2016, 27(8): 1365-1366.
21.	李利英, 于倩. MDT 模式在慢性伤口患者管理中的临床效果分析. 健康大视野, 2020(17): 276.

1. Nussbaum SR, Carter MJ, Fife CE, et al. An economic evaluation of the impact, cost, and medicare policy implications of chronic nonhealing wounds. Value Health, 2018, 21(1): 27-32.
2. 冉兴无, 许樟荣. 以创新促发展, 应对日益增多的难治性糖尿病足溃疡. 四川大学学报(医学版), 2022, 53(6): 945-948.
3. 张纪蔚, 张柏根. 下肢难治性静脉溃疡. 中国实用外科杂志, 2001, 21(5): 269-271.
4. 封红伟, 陈丽琴, 胡绣华, 等. 专科护士为主导多学科慢性伤口护理团队的建立与实践. 国际护理学杂志, 2020, 39(13): 2312-2315.
5. Garcia AN, Costa LDCM, Hancock MJ, et al. McKenzie method of mechanical diagnosis and therapy was slightly more effective than placebo for pain, but not for disability, in patients with chronic non-specific low back pain: a randomised placebo controlled trial with short and longer term follow-up. Br J Sports Med, 2018, 52(9): 594-600.
6. 张海滨, 史海娜, 王旭东. MDT 诊疗模式救治急诊危重批量伤患者的临床应用. 中国急救复苏与灾害医学杂志, 2018, 13(3): 231-233.
7. 杨爱花, 严梅, 秦亚辉. 国内外造口专科护理发展现状. 护理研究, 2016(1): 4-7.
8. 魏在荣, 黄广涛. 慢性创面的治疗进展及创面外科整合治疗模式探讨. 中华烧伤杂志, 2019, 35(11): 824-827.
9. 吴弟群, 罗孟媛, 陈旭, 等. 多学科合作对人工气道患者肺部感染发生率的影响研究. 齐鲁护理杂志, 2019, 25(19): 51-53.
10. 魏群英, 罗彩红, 窦梦. 多学科团队协作模式在急性脑外伤手术患者中的应用. 齐鲁护理杂志, 2021, 27(4): 80-82.
11. 马辉. 造口治疗师(ET)在多学科协作治疗(MDT)中的临床实践进展. 结直肠肛门外科, 2020, 26(2): 247-250.
12. 冯玉婕, 陈麒麟, 封秀萍, 等. 专职护理人员在提升多学科综合门诊诊疗服务中的作用. 齐鲁护理杂志, 2021, 27(7): 88-90.
13. Albright RH, Manohar NB, Murillo JF, et al. Effectiveness of multidisciplinary care teams in reducing major amputation rate in adults with diabetes: a systematic review & meta-analysis. Diabetes Res Clin Pract, 2020, 161: 107996.
14. Joret MO, Osman K, Dean A, et al. Multidisciplinary clinics reduce treatment costs and improve patient outcomes in diabetic foot disease. J Vasc Surg, 2019, 70(3): 806-814.
15. 蒋琪霞, 周济宏, 钱洪波, 等. 跨学科团队合作处理复杂伤口的实践与效果. 中国护理管理, 2018, 18(1): 10-14.
16. Fournier C, Singbo N, Morissette N, et al. Outcomes of diabetic foot ulcers in a tertiary referral interdisciplinary clinic: a retrospective canadian study. Can J Diabetes, 2021, 45(3): 255-260.
17. Shanmugam VK, Angra D, Rahimi H, et al. Vasculitic and autoimmune wounds. J Vasc Surg Venous Lymphat Disord, 2017, 5(2): 280-292.
18. 吴莉萍, 张子云, 娄雪娇, 等. 风湿免疫疾病患者皮肤溃疡的多学科协作综合护理. 护理学杂志, 2022, 37(16): 38-40.
19. 余瑾, 黄站梅, 吴锐, 等. 威伐光促进免疫性溃疡愈合的护理研究. 中国当代医药, 2020, 27(33): 204-206,214.
20. 孙红, 黄汉伟, 曾茹英, 等. 慢性伤口治疗护理团队合作模式的建立与效果评价. 海南医学, 2016, 27(8): 1365-1366.
21. 李利英, 于倩. MDT 模式在慢性伤口患者管理中的临床效果分析. 健康大视野, 2020(17): 276.

Previous Article
马尿泡中毒致意识障碍一例
Next Article
Association between acute kidney injury and clinical outcomes in non-surgical patients receiving intensive cardiac care

West China Medical Journal

Application of multi-disciplinary team model led by enterostomal therapist in the diagnosis and treatment of chronic wounds

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content