摘要
Ⅳ期压疮作为累及全层皮肤、皮下组织,并深达肌肉与骨骼的严重慢性创面,其修复过程漫长且复杂,是临床创面修复领域的重大挑战。单一治疗模式常难以奏效,需构建一套贯穿急性期至修复期、兼顾局部与全身的综合管理策略。本文报告1例74岁高龄、伴有严重营养不良与多种基础疾病的Ⅳ期骶尾部压疮患者。该病例在住院期间接受系统的全身支持治疗、外科清创及负压封闭引流技术以控制感染、促进肉芽生长;病情稳定后,转为居家延续性护理,联合应用传统中药生肌膏与现代生物制剂牛碱性成纤维细胞生长因子溶液,最终实现创面完全上皮化愈合。通过完整展示该病例长达十余周的多阶段、多模式修复历程,探讨以“创面床准备”理论为核心,阶梯式应用不同治疗手段,并辅以强有力营养支持与无缝衔接延续护理相结合的综合策略,在攻克慢性难治性皮肤损伤中的关键作用与临床应用价值。
StageⅣpressure injuries,as severe chronic wounds involving full-thickness skin,subcutaneous tissue,and extending deep into muscle and bone,present a prolonged and complex healing process,representing a major challenge in the field of clinical wound repair.A single treatment modality is often insufficient,necessitating the development of a comprehensive management strategy spanning from the acute phase to the repair phase,addressing both local and systemic factors.This article reports the case of a 74-year-old elderly patient with severe malnutrition and multiple underlying conditions,who presented with a StageⅣsacrococcygeal pressure injury.During hospitalization,the patient received systematic systemic support therapy,surgical debridement,and Vacuum Sealing Drainage(VSD)to control infection and promote granulation tissue formation.After the condition stabilized,the patient transitioned to continuity of care at home,involving the combined application of traditional Chinese medicine Shengji Ointment and the modern biological agent bovine basic Fibroblast Growth Factor(bFGF)solution gel.This approach ultimately resulted in complete wound healing through epithelialization.By comprehensively documenting the multi-stage,multi-modal repair process spanning over ten weeks in this case,this paper delves into the pivotal role and clinical application value of an integrated management strategy.This strategy centers on the"wound bed preparation"theory,employs therapeutic methods in a stepwise manner,and is supplemented by robust nutritional support and seamless continuity of care in addressing challenging chronic refractory skin injuries.
作者
郑爱雅
王清华
吴言
郭天阳
陆捷洁
ZHENG Aiya;WANG Qinghua;WU Yan;GUO Tianyang;LU Jiejie(Department of Dermatology,the Fifth People′s Hospital of Hainan Province,Haikou 570100,China;Department of Orthopaedics,the Fifth People′s Hospital of Hainan Province,Haikou 570100,China;Department of Nursing,the Fifth People′s Hospital of Hainan Province,Haikou 570100,China)
出处
《皮肤科学通报》
2025年第6期691-695,共5页
Dermatology Bulletin
关键词
Ⅳ期压疮
负压封闭引流
创面修复
生肌膏
碱性成纤维细胞生长因子
延续护理
综合管理
Stage IV pressure injury
Vacuum Sealing Drainage
Wound repair
Shengji Ointment
basic Fibroblast Growth Factor
Continuity of care
Comprehensive management
