新型冠状病毒肺炎对某安全网医院糖尿病足溃疡手术的影响

IF 1.4 4区 医学 Q3 DERMATOLOGY
Hau Pham, Ewald Mendeszoon, Vitaliy Volansky, Justin Ogbonna, Wei Tseng, Elizabeth Sanders, David Coker, Ashley Daniel
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引用次数: 0

摘要

背景:糖尿病足溃疡的治疗需要细致和持续的工作。在2020年COVID-19大流行期间实施的社交距离和封锁限制对于挽救生命和防止医院人满为患至关重要,但它们给患者和医疗保健提供者带来了许多困难。目的:了解新冠肺炎疫情对某安全网医院创面护理手术的影响。方法:回顾2018年3月至2023年2月,即2019冠状病毒病大流行元年的前2年、当年和后2年,在同一家机构进行的所有溃疡相关手术。由于从2020年3月开始实施门诊和选择性手术限制,因此将3月至2月作为审查时间。伤口相关手术包括伤口清创、切口引流、外植骨切除术、手指截肢、足中部截肢和大截肢。结果:在整个研究期间,作者所在机构共进行了1858例溃疡相关手术。病例发生前(前)2年内共行手术723例,病例发生第一年(新冠)手术368例,病例发生第一年(后)后2年手术767例。结论:COVID-19对临床溃疡管理的各个方面都有显著影响。作者的伤口诊所仍然在有限的基础上开放,并且看到的患者数量明显较低。取消限制后,伤口护理就诊人数仍明显低于大流行前的水平;对COVID-19的恐惧对就诊人数产生了持久影响。自大流行的第一年以来,外植骨切除术和手指截肢的数量有所增加。在大流行的第一年之后,中足截肢和主要截肢没有太大变化,这可能是由于COVID-19造成的死亡。与COVID-19相关的恐惧和死亡影响了伤口护理,并继续影响伤口护理和肢体抢救,但确定受影响的实际人数具有挑战性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The effect of COVID-19 on diabetic foot ulcer surgery at a safety net hospital.

Background: Management of diabetic foot ulcers requires detailed and continuous work. Social distancing and lockdown restrictions instituted during the COVID-19 pandemic of 2020 were essential to saving lives and preventing hospital overflow, but they caused many difficulties for patients and health care providers.

Objective: To show the changes in wound care surgery affected by COVID-19 at a safety net hospital.

Methods: All ulcer-related surgeries performed at a single institution from March 2018 through February 2023-that is, 2 years before, the year of, and 2 years after the first year of the COVID-19 pandemic-were reviewed. Because the imposed outpatient and elective surgery restrictions started in March 2020, the period from March through February was used for the review. Wound-related surgeries included wound debridement, incision and drainage, exostectomy, digit amputations, midfoot amputations, and major amputations.

Results: During the entire period, 1858 ulcer-related surgeries were performed at the authors' institution. A total of 723 surgeries were performed in the 2 years before COVID (pre), with 368 performed in the initial year of COVID (Covid) and 767 in the 2 years after the first year of the pandemic (post).

Conclusion: COVID-19 significantly impacted various aspects of ulcer management at the clinic. The authors' wound clinic remained open on a limited basis, and the number of patients seen was markedly lower. After the restrictions were lifted, wound care visits remained significantly lower than the pre-pandemic level; the fear of COVID-19 had a lasting impact on the number of visits. The number of exostectomy and digit amputations has increased since the first year of the pandemic. Midfoot amputation and major amputation did not change much after the initial year of the pandemic, which may be due to death from COVID-19. The fear and death associated with COVID-19 affected wound care and continue to affect wound care and limb salvage, but determining the actual number affected is challenging.

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来源期刊
CiteScore
1.50
自引率
11.80%
发文量
77
审稿时长
6-12 weeks
期刊介绍: Wounds is the most widely read, peer-reviewed journal focusing on wound care and wound research. The information disseminated to our readers includes valuable research and commentaries on tissue repair and regeneration, biology and biochemistry of wound healing, and clinical management of various wound etiologies. Our multidisciplinary readership consists of dermatologists, general surgeons, plastic surgeons, vascular surgeons, internal medicine/family practitioners, podiatrists, gerontologists, researchers in industry or academia (PhDs), orthopedic surgeons, infectious disease physicians, nurse practitioners, and physician assistants. These practitioners must be well equipped to deal with a myriad of chronic wound conditions affecting their patients including vascular disease, diabetes, obesity, dermatological disorders, and more. Whether dealing with a traumatic wound, a surgical or non-skin wound, a burn injury, or a diabetic foot ulcer, wound care professionals turn to Wounds for the latest in research and practice in this ever-growing field of medicine.
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