以慢性危重症的理念管理老年难愈性创面

郭光华; 黄圣宇; 朱峰

doi:10.3760/cma.j.cn501225-20250314-00130

以慢性危重症的理念管理老年难愈性创面

doi: 10.3760/cma.j.cn501225-20250314-00130

1.
南昌大学第一附属医院烧伤整形与创面修复医学中心,南昌　　330006
2.
同济大学附属东方医院重症医学科,上海　　200120

基金项目:

国家自然科学基金地区科学基金项目 82160376, 81960352

江西省科技厅重点研发计划重点项目 20171ACG70004

详细信息

通讯作者:
郭光华,Email：guogh2000@hotmail.com

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出版历程
- 收稿日期: 2025-03-14

Managing refractory wounds in the elderly with the concept of chronic critical illness

1.
Medical Center of Burn Plastic and Wound Repair, the First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang 330006, China
2.
Department of Critical Care Medicine, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai 200120, China

Funds:

Regional Science Foundation Project of National Natural Science Foundation of China 82160376, 81960352

Key Program for Key Research and Development Program of Science and Technology Department of Jiangxi Province of China 20171ACG70004

More Information

Corresponding author: Guo Guanghua, Email: guogh2000@hotmail.com

摘要

摘要: 老年人皮肤结构发生改变,皮肤软组织容易受到损伤,从而导致难愈性创面形成的风险增加。老年患者具有特殊的病理生理特征,多伴随严重、复杂的共病（脏器疾病、精神心理问题、老年综合征等）和多药治疗状态,有的患者已长期处于慢性危重症状态。高龄、难愈性创面和危重病在临床中常相互影响,形成恶性循环。老年患者的难愈性创面管理,应视为老年共病管理的重要一环。为此,笔者提出将慢性危重症的理念引入老年难愈性创面管理,通过多学科、动态、分层关注共病和多药治疗状态之间的相互影响,在聚焦老年难愈性创面诊断和治疗的同时,兼顾老年脏器疾病的诊断和治疗、功能维护和实际需求。
- 老年人 /
- 危重病 /
- 危重症护理 /
- 难愈性创面 /
- 创面修复
Abstract: The skin structure undergoes alterations in the elderly, making the skin soft tissue more susceptible to injury and thereby increasing the risk of developing refractory wounds. Elderly patients exhibit unique pathophysiological characteristics, often accompanied by severe and complex comorbidities (such as organ diseases, psychiatric and psychological issues, geriatric syndromes, etc.) and polypharmacy. Some patients may already be in a state of chronic critical illness for an extended period. Advanced age, refractory wounds, and critical illness often interact clinically, creating a vicious cycle. The management of refractory wounds in elderly patients should be regarded as an essential component of the overall management of geriatric comorbidities. To this end, the author proposes incorporating the concept of chronic critical illness into the management of refractory wounds in the elderly, focusing on the interplay between comorbidities and polypharmacy through multidisciplinary, dynamic, and stratified approaches. While focusing on the diagnosis and treatment of refractory wounds in the elderly, it also takes into account the diagnosis and treatment of geriatric organ diseases, functional maintenance, and actual needs.
- Aged /
- Critical illness /
- Critical care nursing /
- Refractory wounds /
- Wound repair
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