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RETRACTION: Effect of drain placement in short-level spinal surgery on postoperative wound infection: A meta-analysis 回放:短位脊柱手术中放置引流管对术后伤口感染的影响:荟萃分析
IF 2.6 3区 医学 Q2 DERMATOLOGY Pub Date : 2024-10-16 DOI: 10.1111/iwj.70112

Retraction: B. Zhan, S. Fang, X. Lv, X. Xie, X. Wang, “ Effect of Drain Placement in Short-Level Spinal Surgery on Postoperative Wound Infection: A Meta-Analysis,” International Wound Journal 21, no. 3 (2024): e14508, https://doi.org/10.1111/iwj.14508.

The above article, published online on 01 December 2023, in Wiley Online Library (http://onlinelibrary.wiley.com/), has been retracted by agreement between the journal Editor in Chief, Professor Keith Harding; and John Wiley & Sons, Ltd. It came to the publisher's attention from a third party that a number of articles shared concerning similarities in format and structure. Following an investigation by the publisher, the retraction has been agreed on as the peer review and publishing process for this article were found to be manipulated. The authors did not respond to the notice of retraction.

撤回: B. Zhan,S. Fang,X. Lv,X. Xie,X. Wang,"脊柱短位手术中引流管放置对术后伤口感染的影响:国际伤口杂志》21,no.3 (2024): e14508, https://doi.org/10.1111/iwj.14508.The 上述文章于 2023 年 12 月 1 日在线发表于 Wiley Online Library (http://onlinelibrary.wiley.com/),经期刊主编 Keith Harding 教授和 John Wiley & Sons, Ltd.(John Wiley & Sons, Ltd.)协商,已被撤回。出版商从第三方处获悉,一些文章在格式和结构上存在相似之处。经出版商调查,发现这篇文章的同行评审和出版过程存在操纵行为,因此同意撤稿。作者未对撤稿通知做出回应。
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引用次数: 0
RETRACTION: Effect of right internal mammary artery versus radial artery as a second graft vessel in coronary artery bypass grafting on postoperative wound infection in patients: A meta-analysis 返回:冠状动脉旁路移植术中右乳内动脉与桡动脉作为第二移植血管对患者术后伤口感染的影响:荟萃分析
IF 2.6 3区 医学 Q2 DERMATOLOGY Pub Date : 2024-10-16 DOI: 10.1111/iwj.70110

Retraction: H. Du, X. Gu, Z. Zhang, Z. Dong, X. Ran, and L. Zhou, “ Effect of Right Internal Mammary Artery Versus Radial Artery as a Second Graft Vessel in Coronary Artery Bypass Grafting on Postoperative Wound Infection in Patients: A Meta-Analysis,” International Wound Journal 21, no. 3 (2024): e14592, https://doi.org/10.1111/iwj.14592.

The above article, published online on 29 February 2024, in Wiley Online Library (http://onlinelibrary.wiley.com/), has been retracted by agreement between the journal Editor in Chief, Professor Keith Harding; and John Wiley & Sons, Ltd. It came to the publisher's attention from a third party that a number of articles shared concerning similarities in format and structure. Following an investigation by the publisher, the retraction has been agreed on as the peer review and publishing process for this article were found to be manipulated. The authors did not respond to the notice of retraction.

撤回: H. Du、X. Gu、Z. Zhang、Z. Dong、X. Ran 和 L. Zhou,"冠状动脉旁路移植术中右乳内动脉与桡动脉作为第二移植血管对患者术后伤口感染的影响:Meta-Analysis," International Wound Journal 21, no.3 (2024): e14592, https://doi.org/10.1111/iwj.14592.The 上述文章于 2024 年 2 月 29 日在线发表于 Wiley Online Library (http://onlinelibrary.wiley.com/),经杂志主编 Keith Harding 教授和 John Wiley & Sons, Ltd.(约翰-威利父子有限公司)协商,已被撤回。出版商从第三方处获悉,一些文章在格式和结构上存在相似之处。经出版商调查,发现这篇文章的同行评审和出版过程存在操纵行为,因此同意撤稿。作者未对撤稿通知做出回应。
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引用次数: 0
RETRACTION: Effect of passive versus active abdominal drainage on wound infection after pancreatectomy: A meta-analysis 返回:被动腹腔引流与主动腹腔引流对胰腺切除术后伤口感染的影响:荟萃分析
IF 2.6 3区 医学 Q2 DERMATOLOGY Pub Date : 2024-10-16 DOI: 10.1111/iwj.70113

Retraction: Y. Han, Z. Wu, J. Song, Q. Zhang, L. Wei, and H. Lu, “ Effect of Passive Versus Active Abdominal Drainage on Wound Infection after Pancreatectomy: A Meta-Analysis,” International Wound Journal 21, no. 3 (2024): e14755, https://doi.org/10.1111/iwj.14755.

The above article, published online on 07 March 2024, in Wiley Online Library (http://onlinelibrary.wiley.com/), has been retracted by agreement between the journal Editor in Chief, Professor Keith Harding; and John Wiley & Sons, Ltd. It came to the publisher's attention from a third party that a number of articles shared concerning similarities in format and structure. Following an investigation by the publisher, the retraction has been agreed on as the peer review and publishing process for this article were found to be manipulated. The authors did not respond to the notice of retraction.

撤回: Y. Han、Z. Wu、J. Song、Q. Zhang、L. Wei 和 H. Lu,"被动腹腔引流与主动腹腔引流对胰腺切除术后伤口感染的影响:国际伤口杂志》21,no.3 (2024): e14755, https://doi.org/10.1111/iwj.14755.The 上述文章于 2024 年 3 月 7 日在线发表于 Wiley Online Library (http://onlinelibrary.wiley.com/),经杂志主编 Keith Harding 教授和 John Wiley & Sons, Ltd.(约翰-威利父子有限公司)协商,已被撤回。出版商从第三方处获悉,一些文章在格式和结构上存在相似之处。经出版商调查,发现这篇文章的同行评审和出版过程存在操纵行为,因此同意撤稿。作者未对撤稿通知做出回应。
{"title":"RETRACTION: Effect of passive versus active abdominal drainage on wound infection after pancreatectomy: A meta-analysis","authors":"","doi":"10.1111/iwj.70113","DOIUrl":"https://doi.org/10.1111/iwj.70113","url":null,"abstract":"<p>Retraction: <span>Y. Han</span>, <span>Z. Wu</span>, <span>J. Song</span>, <span>Q. Zhang</span>, <span>L. Wei</span>, and <span>H. Lu</span>, “ <span>Effect of Passive Versus Active Abdominal Drainage on Wound Infection after Pancreatectomy: A Meta-Analysis</span>,” <i>International Wound Journal</i> <span>21</span>, no. <span>3</span> (<span>2024</span>): e14755, https://doi.org/10.1111/iwj.14755.</p><p>The above article, published online on 07 March 2024, in Wiley Online Library (http://onlinelibrary.wiley.com/), has been retracted by agreement between the journal Editor in Chief, Professor Keith Harding; and John Wiley &amp; Sons, Ltd. It came to the publisher's attention from a third party that a number of articles shared concerning similarities in format and structure. Following an investigation by the publisher, the retraction has been agreed on as the peer review and publishing process for this article were found to be manipulated. The authors did not respond to the notice of retraction.</p>","PeriodicalId":14451,"journal":{"name":"International Wound Journal","volume":"21 10","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/iwj.70113","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142447674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
RETRACTION: Effect of wound infiltration of dexmedetomidine in lumbar spine surgery on postoperative wound pain: A meta-analysis 返回:腰椎手术中伤口浸润右美托咪定对术后伤口疼痛的影响:荟萃分析
IF 2.6 3区 医学 Q2 DERMATOLOGY Pub Date : 2024-10-16 DOI: 10.1111/iwj.70111

Retraction: X. Wang, Y. Peng, Y. Si, and X. Hu, “ Effect of Wound Infiltration of Dexmedetomidine in Lumbar Spine Surgery on Postoperative Wound Pain: A Meta-Analysis,” International Wound Journal 21, no. 3 (2024): e14523, https://doi.org/10.1111/iwj.14523.

The above article, published online on 05 December 2023, in Wiley Online Library (http://onlinelibrary.wiley.com/), has been retracted by agreement between the journal Editor in Chief, Professor Keith Harding; and John Wiley & Sons, Ltd. It came to the publisher's attention from a third party that a number of articles shared concerning similarities in format and structure. Following an investigation by the publisher, the retraction has been agreed on as the peer review and publishing process for this article were found to be manipulated. The authors did not respond to the notice of retraction.

撤回: X. Wang, Y. Peng, Y. Si, and X. Hu, "Effect of Wound Infiltration of Dexmedetomidine in Lumbar Spine Surgery on Postoperative Wound Pain: A Meta-Analysis," International Wound Journal 21, no.3 (2024): e14523, https://doi.org/10.1111/iwj.14523.The 上述文章于 2023 年 12 月 5 日在线发表于 Wiley Online Library (http://onlinelibrary.wiley.com/),经杂志主编 Keith Harding 教授与 John Wiley & Sons, Ltd.(约翰-威利父子有限公司)协商,已被撤回。出版商从第三方处获悉,一些文章在格式和结构上存在相似之处。经出版商调查,发现这篇文章的同行评审和出版过程存在操纵行为,因此同意撤稿。作者未对撤稿通知做出回应。
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引用次数: 0
Low-dose estrogen release from silastic capsule enhanced flap wound healing in an animal model 硅胶囊释放低剂量雌激素促进动物模型皮瓣伤口愈合
IF 2.6 3区 医学 Q2 DERMATOLOGY Pub Date : 2024-10-14 DOI: 10.1111/iwj.70083
Yi-Wen Wang, Chun-Ting Chen, Kai-Chieh Chou, Shih-Ming Huang, Kuang-Ling Ou

Background

Deep and extensive wounds usually cannot be closed directly by suturing or skin grafting. Flap transplantation is typically used to reconstruct large wounds clinically. The flap survival is based on a stable blood perfusion. It is established that estrogen promotes wound healing and angiogenesis, and regulates the inflammatory response, leading to enhanced flap survival after transplantation. However, estrogen concentrations administered in previous studies were significantly higher than physiological levels, potentially causing systemic side effects. Estrogen-sustained-release silastic capsules can maintain blood serum estrogen closer to physiological levels. This study aimed to investigate whether administering estrogen at a lower concentration, closer to physiological levels, could still enhance flap survival.

Materials and Methods

This study was performed in a random skin flap model in ovariectomized (OVX) mice. Sustained-release estrogen silastic capsules were implanted into OVX mice to determine the functional role of estrogen in wound healing after flap transplantation. Flap blood perfusion was analysed using a colour laser Doppler scanner. Immunohistochemical staining of CD31, hypoxia-inducible factor 1 alpha (HIF-1α), alpha–smooth muscle actin (α-SMA), cleaved caspase 3 and apoptotic terminal dUTP nick end-labelling stain was used to investigate flap angiogenesis, tissue hypoxia, wound healing and cell death in the flap tissue, respectively.

Results

We observed that administering estrogen at a lower concentration enhanced superficial blood perfusion while reducing the flap's ischemic area and tissue necrosis. HIF-1α expression was significantly decreased in the dermis layer but not in the fascia, whereas cleaved caspase 3 levels decreased in the fascia but remained unchanged in the dermis. Additionally, there was no significant difference in CD31and α-SMA expression between the groups.

Conclusion

In summary, the study showed that an estrogen silastic capsule maintained physiological estrogen levels and improved superficial perfusion, thereby reducing dermal hypoxia, and cell death in a mouse random pattern skin flap model. Although no significant promotion of angiogenesis was observed, the study suggests that appropriate estrogen supplements could enhance flap wound recovery.

背景 深部和大面积伤口通常无法通过缝合或植皮直接闭合。临床上通常使用皮瓣移植来重建大面积伤口。皮瓣存活的基础是稳定的血液灌注。雌激素可促进伤口愈合和血管生成,调节炎症反应,从而提高皮瓣移植后的存活率。然而,以往研究中使用的雌激素浓度明显高于生理水平,可能会引起全身副作用。雌激素缓释硅胶胶囊可使血清雌激素维持在更接近生理水平的水平。本研究旨在探讨以更接近生理水平的较低浓度给药雌激素是否仍能提高皮瓣存活率。 材料与方法 本研究在卵巢切除(OVX)小鼠的随机皮瓣模型中进行。将雌激素硅胶缓释胶囊植入卵巢切除小鼠体内,以确定雌激素在皮瓣移植后伤口愈合中的功能作用。使用彩色激光多普勒扫描仪分析皮瓣血液灌注情况。采用免疫组织化学染色法对 CD31、缺氧诱导因子 1 α(HIF-1α)、α-平滑肌肌动蛋白(α-SMA)、裂解的 Caspase 3 和凋亡末端 dUTP 缺口末端标记染色法分别研究皮瓣组织的血管生成、组织缺氧、伤口愈合和细胞死亡。 结果 我们观察到,使用较低浓度的雌激素可增强表皮血液灌注,同时减少皮瓣缺血面积和组织坏死。真皮层中 HIF-1α 的表达明显减少,而筋膜层中则没有;筋膜层中裂解的 Caspase 3 水平下降,而真皮层中则保持不变。此外,CD31 和 α-SMA 的表达在各组间无明显差异。 结论 综上所述,该研究表明,雌激素硅胶囊可维持生理雌激素水平,改善表皮灌注,从而减少小鼠随机模式皮瓣模型中的真皮缺氧和细胞死亡。虽然没有观察到明显促进血管生成的作用,但研究表明,适当补充雌激素可促进皮瓣伤口恢复。
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引用次数: 0
Retention processed placental membrane versus standard of care in treating diabetic foot ulcers 在治疗糖尿病足溃疡时保留处理过的胎盘膜与标准护理相比
IF 2.6 3区 医学 Q2 DERMATOLOGY Pub Date : 2024-10-14 DOI: 10.1111/iwj.70096
Robert G. Frykberg, Zwelithini Tunyiswa, Wendy W. Weston

Diabetic foot ulcers (DFUs) are a severe complication for diabetic patients, significantly impacting patient quality of life and healthcare system efficiency. Traditional standard of care (SOC) treatments are inadequate for many patients, necessitating the use of advanced wound care products, such as human placental membranes. We studied a real-world population of large, hard-to-heal and complicated wounds, otherwise under-studied in the wound care literature. To this end, we conducted a retrospective cohort analysis to compare the effectiveness of a human placental amnion/chorion membrane product using retention-based processing (RE-AC) and SOC in managing chronic DFUs. During the study period of September 2021 through April 2024, we collected retrospective observational data from electronic health records of 21 patients treated with RE-AC at three outpatient wound care centres. Additionally, 21 control SOC patients were matched from a wound registry using Coarsened Exact Matching. Patients were categorized into two cohorts based on whether they received RE-AC or SOC. Key metrics included wound size progression and wound closure. The analysis employed Bayesian regression and Hurdle Gamma Analysis of Covariance models. Despite their rather large size (average of 13.8 cm2), our results indicated that RE-AC achieved almost a 10% higher expected wound closure rate compared to SOC at 12 weeks (8.53% [credible interval: 5.60%–10.7%]). Further, for wounds that did not close, RE-AC resulted in a 93.6% (credible interval: 147.7%–41.6) improvement in expected Percent Area Reduction over the SOC group at 12 weeks. We noted that on average, SOC wounds stalled or grew larger. In terms of a risk ratio comparing the study group with SOC, we found a 52% benefit in the RE-AC group (RR = 1.52). The findings suggest that even with larger DFUs, R-AC is superior to SOC for wound closure and expected Percent Area Reduction by 12 weeks. This benefit likely leads to reduced treatment costs, optimized resource utilization and improved outcomes in the DFU patient population; ultimately resulting in improved patient care.

糖尿病足溃疡(DFU)是糖尿病患者的严重并发症,严重影响患者的生活质量和医疗系统的效率。对许多患者来说,传统的标准护理(SOC)疗法是不够的,因此需要使用先进的伤口护理产品,如人胎盘膜。我们研究了现实世界中的大面积、难愈合和复杂伤口人群,这些伤口在伤口护理文献中的研究并不充分。为此,我们进行了一项回顾性队列分析,以比较使用保留型处理(RE-AC)的人胎盘羊膜/绒毛膜产品和 SOC 在管理慢性 DFU 方面的效果。在 2021 年 9 月至 2024 年 4 月的研究期间,我们从三个门诊伤口护理中心的电子健康记录中收集了 21 名接受 RE-AC 治疗的患者的回顾性观察数据。此外,我们还使用粗化精确匹配法从伤口登记处匹配了 21 名 SOC 对照组患者。根据患者接受的是 RE-AC 还是 SOC 治疗,将他们分为两个组群。关键指标包括伤口大小进展和伤口闭合情况。分析采用了贝叶斯回归和赫尔德伽马协方差分析模型。尽管伤口面积相当大(平均 13.8 平方厘米),但我们的结果表明,在 12 周时,RE-AC 的预期伤口闭合率比 SOC 高出近 10%(8.53% [可信区间:5.60%-10.7%])。此外,对于未闭合的伤口,RE-AC 在 12 周时与 SOC 组相比,预期面积缩小百分比提高了 93.6%(可信区间:147.7%-41.6)。我们注意到,平均而言,SOC 组伤口停滞或扩大。通过比较研究组与 SOC 组的风险比,我们发现 RE-AC 组的获益率为 52%(RR = 1.52)。研究结果表明,即使 DFU 较大,R-AC 在 12 周前的伤口闭合和预期面积缩小百分比方面也优于 SOC。这种优势可能会降低治疗成本,优化资源利用,改善 DFU 患者的治疗效果,最终改善患者护理。
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引用次数: 0
Biodegradable Temporising matrix in the reconstruction of complex wounds: A systematic review and meta-analysis 用于复杂伤口重建的生物可降解临时基质:系统回顾与荟萃分析
IF 2.6 3区 医学 Q2 DERMATOLOGY Pub Date : 2024-10-14 DOI: 10.1111/iwj.70025
George Lane, Niall James Fitzpatrick, Olga Kastritsi, Georgios Matzakanis, Fatima Braimah, Mohamad Nazmi M. Nordin, Ayobami Asaju, Fouad Tariq Aziz, Shafiq Rahman, Rebecca Rollett

Objective

To assess the efficacy of biodegradable temporising matrix (BTM) in complex wound reconstruction.

Methods

The authors conducted a systematic review and meta-analysis as per the preferred reporting items for systematic review and meta-analysis (PRISMA) guidelines following a literature search assessing BTM in complex wound reconstruction. The primary outcome measures included the proportion of BTM integration as well as integration time. Secondary outcomes included graft take over BTM, infection rate and other complications as well as scar outcome.

Results

Twenty six studies met the inclusion criteria with a total of 1153 complex wounds. The mean proportional integration was 92.7% at (95% confidence intervals [CI] 88.57, 96.87, p < 0.001) with a mean integration time of 34.05 days (95% CI 33.33, 34.79, p < 0.001). The infection rate was low at 12.6% with an untransformed proportion metric assessment (0.126, 0.08–0.168, p < 0.001) at the site of BTM application. Favourable scar outcomes were reported using the matching assessment using photographs with scars (MAPS) and patient and observer scar assessment scales (POSAS).

Conclusion

BTM offers a robust dermal template in reconstruction of complex wounds. The authors recommend for randomised controlled trials to enhance the current evidence base.

目的 评估生物可降解临时基质(BTM)在复杂伤口重建中的疗效。 方法 作者根据系统综述和荟萃分析首选报告项目(PRISMA)指南进行了系统综述和荟萃分析,并对复杂伤口重建中的 BTM 进行了文献检索。主要结果指标包括 BTM 融合比例和融合时间。次要结果包括移植物对 BTM 的吸收、感染率和其他并发症以及疤痕结果。 结果 符合纳入标准的研究有 26 项,共涉及 1153 个复杂伤口。平均整合比例为 92.7%(95% 置信区间 [CI] 88.57, 96.87, p <0.001),平均整合时间为 34.05 天(95% 置信区间 33.33, 34.79, p <0.001)。BTM 应用部位的感染率较低,仅为 12.6%,未转化比例评估值为 (0.126, 0.08-0.168, p <0.001)。使用疤痕照片配对评估(MAPS)以及患者和观察者疤痕评估量表(POSAS)均报告了良好的疤痕效果。 结论 BTM 为复杂伤口的重建提供了强大的真皮模板。作者建议进行随机对照试验,以加强现有的证据基础。
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引用次数: 0
Post-traumatic growth and its explanatory factors in burn patients: A systematic review 烧伤患者的创伤后成长及其解释因素:系统回顾
IF 2.6 3区 医学 Q2 DERMATOLOGY Pub Date : 2024-10-14 DOI: 10.1111/iwj.70066
Siamak Kazemi-Sufi, Ayub Bagheri, Seyed Amirhossein Mazhari, Bahar Farhadi, Hamidreza Alizadeh-Otaghvar, Morteza Zaboli Mahdiabadi, Masoomeh Najafi, Ramyar Farzan, Reza Salehi

A few studies have examined post-traumatic growth (PTG) after burns, a relatively new area of research. To understand how to promote PTG in burn survivors, we need to know how PTG and coping are presented, how they change over time, and the components that influence development. Based on the criteria of the PRISMA statement, we conducted our initial search on 1 February 2023. This study systematically reviewed relevant studies in five PubMed, Web of Science, Google Scholar, Scopus and Science Direct search databases. The search used the following keywords: Post-traumatic Growth, Psychological Growth, Post-traumatic Growth, Psychological, PTG, Burns and Burn. The two researchers evaluated the quality of the included studies using a 20-item tool called the appraisal tool for cross-sectional studies (AXIS tool). A total of 1396 burn patients participated in 12 studies. Among the studies included in this systematic review, seven were cross-sectional, and five were cohort. The average age of the patients in this study was 35.77 (SD = 10.19). Among the participants, 52.4% were men. The total body surface area (TBSA) percentage in these patients was 32.77 (SD = 16.42). The mean of PTG inventory (PTGI) was 54.08 (SD = 20.46) out of 105, which is a moderate level. Factors such as coping strategies, perceived social support, TBSA, religion/spirituality and severity of burn are positive factors for PTG in burn survivors. Also, factors such as depression, post-traumatic stress disorder and physical and mental recovery are negative factors for PTG in burn survivors. These factors can be improved through targeted intervention strategies, including overall function, quality of life, social support, optimism, hope and new opportunities. There is a need for further research in several areas related to growth, intervention and measurement.

烧伤后创伤后成长(PTG)是一个相对较新的研究领域,目前只有少数几项研究对烧伤后创伤后成长进行了研究。为了了解如何促进烧伤幸存者的创伤后成长,我们需要知道创伤后成长和应对是如何呈现的、它们是如何随着时间的推移而变化的,以及影响创伤后成长的因素。根据 PRISMA 声明的标准,我们于 2023 年 2 月 1 日进行了初步检索。本研究系统地审查了 PubMed、Web of Science、Google Scholar、Scopus 和 Science Direct 五个搜索数据库中的相关研究。搜索使用了以下关键词创伤后成长、心理成长、创伤后成长、心理、PTG、烧伤和烧伤。两位研究人员使用一种名为 "横断面研究评估工具"(AXIS 工具)的 20 项工具对纳入研究的质量进行了评估。共有 1396 名烧伤患者参与了 12 项研究。在纳入本系统综述的研究中,7 项为横断面研究,5 项为队列研究。本研究中患者的平均年龄为 35.77 岁(SD = 10.19)。参与者中 52.4% 为男性。这些患者的总体表面积(TBSA)百分比为 32.77(SD = 16.42)。在 105 人中,PTG 库存(PTGI)的平均值为 54.08(SD = 20.46),属于中等水平。应对策略、感知到的社会支持、TBSA、宗教/精神信仰和烧伤严重程度等因素是烧伤幸存者PTG的积极因素。此外,抑郁、创伤后应激障碍和身心康复等因素也是烧伤幸存者PTG的负面因素。这些因素可以通过有针对性的干预策略得到改善,包括整体功能、生活质量、社会支持、乐观、希望和新机会。在与成长、干预和测量相关的几个领域,还需要进一步的研究。
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引用次数: 0
Cost-effectiveness analysis of the geko™ device (an NMES technology) in managing venous leg ulcers in UK healthcare settings 对 geko™ 设备(一种 NMES 技术)在英国医疗机构治疗静脉腿部溃疡的成本效益分析
IF 2.6 3区 医学 Q2 DERMATOLOGY Pub Date : 2024-10-13 DOI: 10.1111/iwj.70048
Richard Tuson, Andrew Metry, Keith Harding

This study evaluates the cost-effectiveness of the geko device a neuromuscular electro-stimulator technology with standard of care (SoC) versus SoC alone for venous leg ulcer (VLU) treatment, from the UK National Health Service (NHS) perspective over 12 months. Research was conducted across NHS UK facilities, primarily within community services and outpatient leg ulcer clinics, encompassing a total of 51 patients. A partitioned survival model, based on a two-arm randomised controlled trial, assessed wound healing rates using Kaplan–Meier curves and parametric extrapolations over a 12-month time horizon. Costs were derived from UK reference costs the British National Formulary, and the Personal Social Services Research Unit (2021/22). The primary outcome measured was the incremental cost per quality-adjusted life-year gained. The geko device provides additional benefits by stimulating the lateral popliteal nerve, augmenting venous, arterial, and microvascular flow. The addition of the geko device to SoC significantly enhanced outcomes, increasing healing probability by 68% compared to SoC. This integration would result in a cost saving of £774.14 per patient when compared to the SoC alone across the NHS. Economic analyses indicate that integrating the geko device into SoC protocols would reduce the overall NHS expenditure on VLU wound management by as much as 15%. The approach also positively impacted health-related quality of life. The geko™ device when used adjunctively with SoC would be a cost-effective method for managing chronic VLUs within the NHS, improving healing rates and offering economic benefits.

这项研究从英国国家医疗服务系统(NHS)的角度,评估了 geko 设备(一种神经肌肉电刺激器技术)与标准护理(SoC)在 12 个月内治疗静脉腿部溃疡(VLU)的成本效益对比。研究在英国国家医疗服务系统(NHS)各机构内进行,主要是在社区服务和腿部溃疡门诊,共涉及 51 名患者。基于双臂随机对照试验的分区生存模型使用卡普兰-梅耶曲线和参数推断法评估了 12 个月内的伤口愈合率。成本来自英国参考成本、英国国家处方集和个人社会服务研究单位(2021/22)。衡量的主要结果是每获得质量调整生命年的增量成本。geko 设备通过刺激腘绳肌外侧神经,增强静脉、动脉和微血管流量,带来了额外的益处。与 SoC 相比,在 SoC 的基础上增加 geko 设备可显著提高疗效,将愈合概率提高 68%。在国家医疗服务体系中,与单独使用 SoC 相比,这种整合可为每位患者节省 774.14 英镑的成本。经济学分析表明,将 geko 设备整合到 SoC 方案中,可使国家医疗服务体系在 VLU 伤口管理方面的总支出减少 15%。这种方法还对与健康相关的生活质量产生了积极影响。geko™设备在与SoC辅助使用时,将成为NHS管理慢性VLU的一种经济有效的方法,可提高愈合率并带来经济效益。
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引用次数: 0
Virtual reality as a promising method of pain relief in patients with venous leg ulcers 虚拟现实技术有望缓解腿部静脉溃疡患者的疼痛
IF 2.6 3区 医学 Q2 DERMATOLOGY Pub Date : 2024-10-13 DOI: 10.1111/iwj.70082
Kinga Spyrka, Ewa Rojczyk, Jakub Brela, Aleksander Sieroń, Marek Kucharzewski

Pain in patients suffering from hard-to-heal wounds is a serious problem that hinders the healing process and affects their quality of life. Virtual reality (VR) is increasingly being used for pain relief. The aim of the study was to assess whether the use of VR during mechanical cleansing of venous leg ulcers would result in a reduction in patients' pain. Sixty patients were randomly divided into two groups. The experimental group included patients who used VR goggles during wound cleansing, and the control group included patients who did not use such equipment during wound cleansing. The Oculus Quest 2 VR Goggles were used in the experiment. After wound cleaning, the patient assessed the intensity of his pain on a numerical pain rating scale from 0 to 10 points. The difference between the intensity of pain during wound cleansing in patients from the experimental and control group turned out to be statistically significant (p < 0.001). It was on average 1.13 ± 0.68 points in the experimental group, and in the case of people from the control group, it was 4.73 ± 1.2 points. To conclude, the use of VR in patients with venous leg ulcers reduces pain during wound cleansing.

伤口难以愈合患者的疼痛是一个严重的问题,它阻碍了伤口的愈合过程,影响了患者的生活质量。虚拟现实(VR)越来越多地被用于缓解疼痛。这项研究的目的是评估在机械清洗腿部静脉溃疡时使用 VR 是否会减轻患者的疼痛。60 名患者被随机分为两组。实验组包括在清洗伤口时使用 VR 护目镜的患者,对照组包括在清洗伤口时不使用此类设备的患者。实验中使用的是 Oculus Quest 2 VR 护目镜。清洗伤口后,患者用 0 到 10 分的疼痛评分表来评估自己的疼痛强度。结果显示,实验组和对照组患者在清洗伤口时的疼痛强度差异具有统计学意义(p < 0.001)。实验组平均为 1.13 ± 0.68 分,对照组为 4.73 ± 1.2 分。总之,静脉性腿部溃疡患者使用 VR 可以减轻清洗伤口时的疼痛。
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International Wound Journal
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