Laura Suoniemi, Teea Salmi, Heini Huhtala, Ilkka Kaartinen, Juha Kiiski, Teija Kimpimäki
{"title":"多学科伤口中心在治疗血管性溃疡和脓皮病溃疡中的作用。","authors":"Laura Suoniemi, Teea Salmi, Heini Huhtala, Ilkka Kaartinen, Juha Kiiski, Teija Kimpimäki","doi":"10.1111/iwj.14943","DOIUrl":null,"url":null,"abstract":"<p>Vasculitic and pyoderma gangrenosum ulcers are traditionally treated with immunosuppressants, and the role of surgery in the treatment of these atypical ulcers remains unclear. This study aimed to investigate the need for surgical intervention as well as the outcome and safety of skin grafting in the treatment of 46 patients with vasculitic ulcers and 34 with pyoderma gangrenosum ulcers using data recorded in the validated Wound Registry. Of the 80 patients with atypical ulcers, 14% (<i>n</i> = 11) were treated surgically; these patients were older (<i>p</i> = 0.039), had lower mobility status (<i>p</i> = 0.002), and more often pulmonary diseases, rheumatoid arthritis, and previous arterial procedures (<i>p</i> = 0.007; <i>p</i> = 0.031; <i>p</i> = 0.031, respectively) than those treated conservatively. Of 181 ulcers, 15% (<i>n</i> = 27) were surgically treated, 78% once and 22% multiple times. During follow-up, 92.3% of both surgically and conservatively treated ulcers with available data healed. Of the surgically treated ulcers, median healing time after first surgical procedure was 96 days, and post-surgical complications were considered mild or unrelated to surgery. Our results suggest that if surgery is indicated, skin grafting is a safe and efficient treatment method provided that multidisciplinary approach is applied.</p>","PeriodicalId":14451,"journal":{"name":"International Wound Journal","volume":null,"pages":null},"PeriodicalIF":2.6000,"publicationDate":"2024-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/iwj.14943","citationCount":"0","resultStr":"{\"title\":\"The role of split-thickness skin grafting in the treatment of vasculitic and pyoderma gangrenosum ulcers in a multidisciplinary wound centre\",\"authors\":\"Laura Suoniemi, Teea Salmi, Heini Huhtala, Ilkka Kaartinen, Juha Kiiski, Teija Kimpimäki\",\"doi\":\"10.1111/iwj.14943\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p>Vasculitic and pyoderma gangrenosum ulcers are traditionally treated with immunosuppressants, and the role of surgery in the treatment of these atypical ulcers remains unclear. This study aimed to investigate the need for surgical intervention as well as the outcome and safety of skin grafting in the treatment of 46 patients with vasculitic ulcers and 34 with pyoderma gangrenosum ulcers using data recorded in the validated Wound Registry. Of the 80 patients with atypical ulcers, 14% (<i>n</i> = 11) were treated surgically; these patients were older (<i>p</i> = 0.039), had lower mobility status (<i>p</i> = 0.002), and more often pulmonary diseases, rheumatoid arthritis, and previous arterial procedures (<i>p</i> = 0.007; <i>p</i> = 0.031; <i>p</i> = 0.031, respectively) than those treated conservatively. Of 181 ulcers, 15% (<i>n</i> = 27) were surgically treated, 78% once and 22% multiple times. During follow-up, 92.3% of both surgically and conservatively treated ulcers with available data healed. Of the surgically treated ulcers, median healing time after first surgical procedure was 96 days, and post-surgical complications were considered mild or unrelated to surgery. Our results suggest that if surgery is indicated, skin grafting is a safe and efficient treatment method provided that multidisciplinary approach is applied.</p>\",\"PeriodicalId\":14451,\"journal\":{\"name\":\"International Wound Journal\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.6000,\"publicationDate\":\"2024-06-20\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1111/iwj.14943\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Wound Journal\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/iwj.14943\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"DERMATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Wound Journal","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/iwj.14943","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"DERMATOLOGY","Score":null,"Total":0}
The role of split-thickness skin grafting in the treatment of vasculitic and pyoderma gangrenosum ulcers in a multidisciplinary wound centre
Vasculitic and pyoderma gangrenosum ulcers are traditionally treated with immunosuppressants, and the role of surgery in the treatment of these atypical ulcers remains unclear. This study aimed to investigate the need for surgical intervention as well as the outcome and safety of skin grafting in the treatment of 46 patients with vasculitic ulcers and 34 with pyoderma gangrenosum ulcers using data recorded in the validated Wound Registry. Of the 80 patients with atypical ulcers, 14% (n = 11) were treated surgically; these patients were older (p = 0.039), had lower mobility status (p = 0.002), and more often pulmonary diseases, rheumatoid arthritis, and previous arterial procedures (p = 0.007; p = 0.031; p = 0.031, respectively) than those treated conservatively. Of 181 ulcers, 15% (n = 27) were surgically treated, 78% once and 22% multiple times. During follow-up, 92.3% of both surgically and conservatively treated ulcers with available data healed. Of the surgically treated ulcers, median healing time after first surgical procedure was 96 days, and post-surgical complications were considered mild or unrelated to surgery. Our results suggest that if surgery is indicated, skin grafting is a safe and efficient treatment method provided that multidisciplinary approach is applied.
期刊介绍:
The Editors welcome papers on all aspects of prevention and treatment of wounds and associated conditions in the fields of surgery, dermatology, oncology, nursing, radiotherapy, physical therapy, occupational therapy and podiatry. The Journal accepts papers in the following categories:
- Research papers
- Review articles
- Clinical studies
- Letters
- News and Views: international perspectives, education initiatives, guidelines and different activities of groups and societies.
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The Editors are supported by a board of international experts and a panel of reviewers across a range of disciplines and specialties which ensures only the most current and relevant research is published.