The Wound Care Center of West China Hospital of Sichuan University is motivated by professional and high-quality solutions to patients’ wound problems. It has explored and carried out a variety of wound treatment modes, such as wound care specialist clinic, wound nursing expert clinic, integrated wound multiple disciplinary team clinic and complex and difficult wound consultation. Under the multi-mode management of wound treatment, patients with all levels and all types of wounds are treated in an orderly manner, which has effectively promoted the development of wound care to a deeper level, a wider range and a higher level. This paper introduces the experience of multi-mode wound treatment in Wound Care Center from the aspects of organizational structure and treatment process, wound outpatient management, wound treatment competence matching and multi-mode operation. The purpose is to provide a reference for the management of related departments in similar hospitals.
Bacterial biofilm is the key problem of chronic wound infection and difficult healing. How to prevent and control bacterial biofilm and improve the prognosis of chronic wound has become a research hotspot in the field of wound care. This paper will summarize from the following aspects: four major stages in the process of chronic wound bacteria biofilm formation (surface adhesion, formation of small colonies, biofilm maturation, and dispersion and separation); characteristics of host immune response in the presence of biofilms; morphological, microbiological, and molecular detection methods for biofilms; and progress in in vitro trials, animal trials, clinical trials, and new therapeutic methods of biofilm. The purpose of this review is to provide evidence for the treatment of biofilms for chronic wounds.
Objective To explore the effect of constructing the closed-loop management of the wound in the day surgery patients and to reduce the incidence of poor wound healing after day surgery. Methods The medical records of patients with closed-loop wound management mode in the Day Surgery Center of West China Hospital of Sichuan University from 2019 to 2020 were collected retrospectively. The general data of patients were collected, and the cases of delayed wound healing after operation were counted. Results A total of 17 801 patients were included, 9 802 in 2019 and 7 999 in 2020. Laparoscopic cholecystectomy and adult tension-free hernia repair were the most common methods of delayed wound healing in day surgery. In the closed-loop management mode, the incidence of delayed wound healing was 0.98% (174/17 801) and the incidence of dissatisfaction related to delayed wound healing was 0.034% (6/17 801). Conclusion The clinical application of the closed-loop management of the wound in the day surgery can promote the early healing of day surgery patients, guarantee the quality of day surgery, and improve patient satisfaction.
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.
ObjectiveTo evaluate the feasibility of novel coronavirus infection rapid screening tool for liver transplantation donors.MethodsClinical data of 14 cases of organ donation for cardiac death from February 2020 to May 2020 were collected, and risk screening was conducted by using novel coronavirus infection rapid screening tool of liver transplantation donor.ResultsThe risk screening results of 14 donors showed that 9 were at moderate risk and 5 were at low risk. After two negative nucleic acid tests and case discussion, the organ of 9 medium-risk donors could be used. Ten cases were performed the liver transplantion, and all patients recovered smoothly after operation, and no novel coronavirus infection occurred.ConclusionNovel coronavirus rapid screening tool for liver transplantation has shown certain clinical value, which needs to be further verified and improved.
ObjectiveTo investigate the psychology and sleep statuses of liver transplantation recipients during the outbreak of COVID-19.MethodsCluster sampling was used to investigate the patients who underwent liver transplantation in the West China Hospital of Sichuan University from January to February 2020. The psychology and sleep statuses were evaluated by the self-designed questionnaire, State-Trait Anxiety Inventory (SAI), Center for Epidemiological Studies Depression Scale (CES-D), and Pittsburgh sleep quality index (PSQI).ResultsTwenty-seven liver transplantation recipients were included in this study. The questionnaires of the 27 patients were collected. The SAI score was (46.41±8.77); The score of CES-D was (13.11±7.87), there were 2 (7.4%) patients with depression; The PSQI score was (6.44±4.02), there were 7 (25.9%) patients with sleep disorders. The points of anxiety and depression of the patients with different gender, age, education level, marital status, residence, living conditions, primary disease, Child-Pugh classification, whether suffered SARS epidemics, COVID-19 knowledges level, medical insurance, family annual income per capita, and income and expenditure of cash had no significant differences (P>0.05) during the outbreak of COVID-19. However, the points of patients with male or suffered SARS or the family annual income per capita ≥60 000 yuan were higher than those of patients with female or not-suffered SARS or the family annual income per capita <60 000 yuan (P<0.05).ConclusionsAnxiety and sleep disorder of liver transplantation recipients are common during the outbreak of COVID-19, which could not be ignored. Knowledges of COVID-19 should be paid to spread so as to reduce psychological pressure and improve sleep quality.
ObjectiveTo construct a rapid screening tool for the donor of heart dead organ donation (donation after circulatory death, DCD) in the background of novel coronavirus (SARS-CoV-2) infection.MethodsBased on literature analysis and core group discussion, two rounds of expert consultation were carried out by Delphi method to establish dimension and index.ResultsThe screening tool included 3 dimensions, including epidemiological history, hospital exposure history, and clinical manifestations, with 15 entries. The mean of the two rounds of expert authority coefficient was 0.757 and 0.768, and the effective recovery rate of the expert consultation questionnaire was 88% and 100%, respectively. The second round dimension and index coordination coefficients was 0.417 and 0.319, respectively. The content validity of the questionnaire was 0.91.ConclusionsThe DCD liver transplant donor's new rapid screening tool for SARS-CoV-2 infection is scientific and reliable. During the epidemic period, the DCD liver transplant donor risk screening tool is of great significance to the prevention and control of liver transplantation risk.