Characteristics of patients with tuberculous wounds and non-tuberculous chronic refractory wounds in single center

Objective To explore the characteristics of patients with tuberculous wounds and non-tuberculous chronic refractory wounds in single center. Methods From January 2010 to June 2017, 43 patients with tuberculous wounds and 44 patients with non-tuberculous chronic refractory wounds admitted to the Department of Burns and Plastic Surgery of the Eighth Medical Center of the General Hospital of the Chinese People′s Liberation Army were conforming to the inclusion criteria. The patients were assigned to tuberculous wound group and non-tuberculous wound group, respectively, and their clinical records were retrospectively analyzed. The gender, place of residence, history of trauma, time of wound formation, time of wound diagnosis, number and length of hospital stay, age, wound site, wound area, sinus occurrence, number of dressing change, number of operation, vacuum sealing drainage (VSD) treatment, recovery, source of medical expense, expense paid by social basic medical insurance and the self-payment of patients in the 2 groups were investigated. Data were processed with independent sample t test and chi-square test. Results (1) Except for gender (χ²=0.019, P>0.05), there were significantly statistical differences in place of residence, history of trauma, time of wound formation, time of wound diagnosis, number and length of hospital stay between patients in tuberculous wound group and non-tuberculous wound group (χ²=4.535, 27.651, t=7.252, 16.131, 4.663, 7.416, P<0.05 or P<0.01). (2) There was no statistically significant difference in the composition ratio of age between patients in tuberculous wound group and non-tuberculous wound group (χ²=11.522, P>0.05). (3) The wounds of patients in tuberculous wound group were more common in the chest, and the wounds of patients in non-tuberculous wound group were more common in the lower limbs. There was statistically significant difference in the composition ratio of the wound sites between patients in the two groups (χ²=28.450, P<0.01). (4) There were statistically significant differences in wound area, sinus occurrence, number of dressing change, number of operation between patients in tuberculous wound group and non-tuberculous wound group (t=-8.524, 9.846, -15.426, 4.663, P<0.01). There were no statistically significant differences in VSD treatment and recovery between patients in the two groups (χ²=0.032, 0.111, P>0.05). (5) The medical expenses of patients in tuberculous wound group from social basic medical insurance, free medical service, the self-paid, and military medical services accounted for 48.8% (21/43), 7.0% (3/43), 39.5% (17/43), and 4.7% (2/43), respectively. The medical expenses of patients in non-tuberculous wound group from social basic medical insurance, free medical service, the self-paid, and military medical services accounted for 59.1% (26/44), 4.5% (2/44), 29.5% (13/44), and 6.8% (3/44), respectively. There was no statistically significant difference in the composition ratio of sources of medical expense between patients in the two groups (χ²=1.154, P>0.05). (6) There were statistically significant differences in expenses for diagnosis, medicine, surgery, examination, laboratory test, and bed, and total expenses paid by social basic medical insurance and the self-payment between patients in tuberculous wound group and non-tuberculous wound group (t=45.051, 39.995, 64.212, 32.584, 8.754, 43.991, 15.671, 17.640, 65.155, 35.546, 35.903, -4.329, 3.344, 12.984, P<0.01). Conclusions Compared with those of patients with non-tuberculous chronic refractory wounds, the tuberculous wounds of patients have longer formation time, the diagnosis and treatment of the wounds are difficult, their wounds are mostly distributed in the chest and often accompanied by sinus formation, and patients with the wounds have long hospital stay and high medical expenses. Besides, the medical expenses for treating wounds of patients in the two groups are mainly paid by social basic medical insurance and the patients themselves.