{"title":"[家庭医学对慢性伤口患者的个体化治疗]。","authors":"T Sinožić, M Katić, J Kovačević","doi":"","DOIUrl":null,"url":null,"abstract":"<p><p>It can be said that the occurrence and development of wounds, healing, delayed healing, and the notion of chronic wound\nare some of the basic characteristics of all living beings. When it comes to people, there are a number of processes that take\nplace during wound healing, and even under ideal circumstances, they create a functionally less valuable skin tissue, along\nwith structural and functional changes. Fibrosis in the form of hypertrophic scars and keloids, contractures and adhesions\nare examples of excessive healing. Microcirculation is significantly different from healthy skin circulation with consequential\nformation of local hypoxia and stagnation in lymph flow with edema. Poor functionality of the scar tissue, particularly in the\nareas exposed to stronger forces, can cause forming of wounds. Such wounds are hard to heal despite the inexistence of\nother possible reasons for delayed healing, precisely because of their poor functionality and placement. The presence of\nwound requiring long-term treatment affects all areas of patient life and leads to decline in the quality of life. Exemplified by\ncase presentation of a patient with post-traumatic wound in the scar area, in our office we showed a model of care based\non the principle of overall personalized care with the biopsychosocial approach. Diagnostic and therapeutic procedures included\nwound assessment, biofilm and lymphedema detection, assessment of the patient’s psychosocial status, risk factors\nfor wound healing, vascular ultrasound diagnostics, carboxytherapy as specialized adjuvant therapy, use of modern wound\ndressings, and compression therapy. Supportive psychotherapy was conducted in positive communication environment\nduring treatment. In this way, in an atmosphere of cooperation with the patient, it was possible not only to influence the\nprocess of wound healing as the primary objective, but also to improve the quality of the patient’s life, as well as to influence\nour professional satisfaction with the results achieved. Family doctors are involved in the care of chronic wound patients\nas part of the multidisciplinary team of experts. Additional specific knowledge and skills are required for such care in order\nto ensure overall quality care as a supplement of the existing knowledge, skills and working experience in family medicine.</p>","PeriodicalId":35756,"journal":{"name":"Acta Medica Croatica","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"[PERSONALIZED APPROACH TO PATIENT WITH CHRONIC WOUND IN FAMILY MEDICINE].\",\"authors\":\"T Sinožić, M Katić, J Kovačević\",\"doi\":\"\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>It can be said that the occurrence and development of wounds, healing, delayed healing, and the notion of chronic wound\\nare some of the basic characteristics of all living beings. When it comes to people, there are a number of processes that take\\nplace during wound healing, and even under ideal circumstances, they create a functionally less valuable skin tissue, along\\nwith structural and functional changes. Fibrosis in the form of hypertrophic scars and keloids, contractures and adhesions\\nare examples of excessive healing. Microcirculation is significantly different from healthy skin circulation with consequential\\nformation of local hypoxia and stagnation in lymph flow with edema. Poor functionality of the scar tissue, particularly in the\\nareas exposed to stronger forces, can cause forming of wounds. Such wounds are hard to heal despite the inexistence of\\nother possible reasons for delayed healing, precisely because of their poor functionality and placement. The presence of\\nwound requiring long-term treatment affects all areas of patient life and leads to decline in the quality of life. Exemplified by\\ncase presentation of a patient with post-traumatic wound in the scar area, in our office we showed a model of care based\\non the principle of overall personalized care with the biopsychosocial approach. Diagnostic and therapeutic procedures included\\nwound assessment, biofilm and lymphedema detection, assessment of the patient’s psychosocial status, risk factors\\nfor wound healing, vascular ultrasound diagnostics, carboxytherapy as specialized adjuvant therapy, use of modern wound\\ndressings, and compression therapy. Supportive psychotherapy was conducted in positive communication environment\\nduring treatment. In this way, in an atmosphere of cooperation with the patient, it was possible not only to influence the\\nprocess of wound healing as the primary objective, but also to improve the quality of the patient’s life, as well as to influence\\nour professional satisfaction with the results achieved. Family doctors are involved in the care of chronic wound patients\\nas part of the multidisciplinary team of experts. Additional specific knowledge and skills are required for such care in order\\nto ensure overall quality care as a supplement of the existing knowledge, skills and working experience in family medicine.</p>\",\"PeriodicalId\":35756,\"journal\":{\"name\":\"Acta Medica Croatica\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2016-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Acta Medica Croatica\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Acta Medica Croatica","FirstCategoryId":"1085","ListUrlMain":"","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}
[PERSONALIZED APPROACH TO PATIENT WITH CHRONIC WOUND IN FAMILY MEDICINE].
It can be said that the occurrence and development of wounds, healing, delayed healing, and the notion of chronic wound
are some of the basic characteristics of all living beings. When it comes to people, there are a number of processes that take
place during wound healing, and even under ideal circumstances, they create a functionally less valuable skin tissue, along
with structural and functional changes. Fibrosis in the form of hypertrophic scars and keloids, contractures and adhesions
are examples of excessive healing. Microcirculation is significantly different from healthy skin circulation with consequential
formation of local hypoxia and stagnation in lymph flow with edema. Poor functionality of the scar tissue, particularly in the
areas exposed to stronger forces, can cause forming of wounds. Such wounds are hard to heal despite the inexistence of
other possible reasons for delayed healing, precisely because of their poor functionality and placement. The presence of
wound requiring long-term treatment affects all areas of patient life and leads to decline in the quality of life. Exemplified by
case presentation of a patient with post-traumatic wound in the scar area, in our office we showed a model of care based
on the principle of overall personalized care with the biopsychosocial approach. Diagnostic and therapeutic procedures included
wound assessment, biofilm and lymphedema detection, assessment of the patient’s psychosocial status, risk factors
for wound healing, vascular ultrasound diagnostics, carboxytherapy as specialized adjuvant therapy, use of modern wound
dressings, and compression therapy. Supportive psychotherapy was conducted in positive communication environment
during treatment. In this way, in an atmosphere of cooperation with the patient, it was possible not only to influence the
process of wound healing as the primary objective, but also to improve the quality of the patient’s life, as well as to influence
our professional satisfaction with the results achieved. Family doctors are involved in the care of chronic wound patients
as part of the multidisciplinary team of experts. Additional specific knowledge and skills are required for such care in order
to ensure overall quality care as a supplement of the existing knowledge, skills and working experience in family medicine.
期刊介绍:
ACTA MEDICA CROATICA publishes original contributions to medical sciences, that have not been previously published. All manuscripts should be written in English.