创伤骨科慢性难愈性创面诊疗指南(2023版)  

Guideline for the diagnosis and treatment of chronic refractory wounds in orthopedic trauma patients(version 2023)

作　　者：熊元[1] 米博斌 闫晨晨 李卉 周武[1] 孙云 夏天[1] 曹发奇 侯志勇[2] 于腾波 喻爱喜[4] 赵猛[5] 谢肇 赵劲民[7] 吴新宝[8] 蒋协远[8] 余斌[9] 张殿英[10] 吴丹凯[11] 刘光耀[12] 刘国栋 花奇凯[7] 刘梦非 胡益强 程鹏 薛航 卢力 楚翔宇 胡良聪 陈朗 查康康 林传陆 余臣焱 陶然阳 林泽 谢旭东 韩艳玖 郭晓东[1] 叶哲伟[1] 周启胜 刘勇[1] 王俊文[14] 夏平[15] 车彪 胡冰 何承建[18] 王光林[19] 王栋梁[20] 林凤飞 倪江东[22] 王爱国 傅德皓 董世武 陈林 许新忠[25] 苏佳灿 唐佩福[26] 姜保国[10] 张英泽[2] 付小兵 刘国辉[1] 中国医师协会骨科医师分会 中华医学会骨科学分会 中华医学会创伤学分会 中国医师协会急救复苏专业委员会创伤骨科与多发伤学组 Xiong Yuan;Mi Bobin;Yan Chenchen;Li Hui;Zhou Wu;Sun Yun;Xia Tian;Cao Faqi;Hou Zhiyong;Yu Tengbo;Yu Aixi;Zhao Meng;Xie Zhao;Zhao Jinmin;Wu Xinbao;Jiang Xieyuan;Yu Bin;Zhang Dianying;Wu Dankai;Liu Guangyao;Liu Guodong;Hua Qikai;Liu Mengfei;Hu Yiqiang;Cheng Peng;Xue Hang;Lu Li;Chu Xiangyu;Hu Liangcong;Chen Lang;Zha Kangkang;Lin Chuanlu;Yu Chengyan;Tao Ranyang;Lin Ze;Xie Xudong;Han Yanjiu;Guo Xiaodong;Ye Zhewei;Zhou Qisheng;Liu Yong;Wang Junwen;Xia Ping;Che Biao;Hu Bing;He Chengjian;Wang Guanglin;Wang Dongliang;Lin Fengfei;Ni Jiangdong;Wang Aiguo;Fu Dehao;Dong Shiwu;Chen Lin;Xu Xinzhong;Su Jiacan;Tang Peifu;Jiang Baoguo;Zhang Yingze;Fu Xiaobing;Liu Guohui;Chinese Association of Orthopedic Surgeons;Chinese Orthopedic Association;Chinese Society of Traumatology;Trauma Orthopedics and Multiple Traumatology Group of Emergency Resuscitation Committee of ChineseMedical Doctor Association(Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430022,China;Third Hospital of Hebei Medical University,Shijiazhuang 050051,China;Qingdao Municipal Hospital(Group),Qingdao 266072,China;Zhongnan Hospital of Wuhan University,Wuhan 430062,China;Taihe Hospital of Shiyan City,Shiyan 442000,China;First Affiliated Hospital of Army Medical University,Chongqing 400038,China;First Affiliated Hospital of Guangxi Medical University,Nanning 530021,China;Beijing Jishuitan Hospital,Beijing 100035,China;Nanfang Hospital,Southern Medical University,Guangzhou 510515,China;People′s Hospital of Peking University,Beijing 100044,China;Second Hospital of Jilin University,Changchun 130041,China;China‑Japan Friendship Hospital,Jilin University,Changchun 130033,China;Daping Hospital,Army Medical University,Chongqing 400042,China;Fourth Hospital of Wuhan,Wuhan 430030,China;First Hospital of Wuhan,Wuhan 430022,China;Department of Orthopedics,Changjiang Shipping General Hospital,Wuhan 430010,China;Tianyou Hospital,Wuhan University of Science and Technology,Wuhan 430064,China;Hubei Hospital of Traditional Chinese Medicine,W

机构地区：[1]华中科技大学同济医学院附属协和医院,武汉430022 [2]河北医科大学第三医院,石家庄050051 [3]青岛市市立医院(集团),青岛266072 [4]武汉大学中南医院,武汉430062 [5]十堰市太和医院,十堰442000 [6]陆军军医大学第一附属医院,重庆400038 [7]广西医科大学第一附属医院,南宁530021 [8]北京积水潭医院,北京100035 [9]南方医科大学南方医院,广州510515 [10]北京大学人民医院,北京100044 [11]吉林大学第二医院,长春130041 [12]吉林大学中日联谊医院,长春130033 [13]陆军军医大学大坪医院,重庆400042 [14]武汉市第四医院,武汉430030 [15]武汉市第一医院,武汉430022 [16]长江航运总医院,武汉430010 [17]武汉科技大学天佑医院,武汉430064 [18]湖北省中医院,武汉430060 [19]四川大学华西医院,成都610041 [20]上海交通大学医学院附属新华医院,上海200092 [21]厦门大学附属福州第二医院,厦门361005 [22]中南大学湘雅二医院,长沙410012 [23]河南大学附属郑州市骨科医院,郑州450015 [24]上海交通大学医学院附属第六人民医院,上海200235 [25]安徽医科大学第二附属医院,合肥230601 [26]中国人民解放军总医院,北京100142 [27]中国人民解放军总医院第一医学中心,北京100037 [28]不详

出　　处：《中华创伤杂志》2023年第6期481-493,共13页Chinese Journal of Trauma

基　　金：国家卫计委重大疾病科技行动防治计划创伤修复重大专项(ZX-01-C2016153,ZX-01-018);国家科技部重点研发计划(2021YFA1101500);国家自然科学基金(82072444,82202714,82272491);中国高校产学研创新基金(2021JH027);湖北省重点研发计划(2020BCB004)。

摘　　要：慢性难愈性创面(CRW)因其发病机制复杂、病程较长及预后差等原因,是临床上面临的最具挑战性难题之一。针对CRW病因复杂、疗效不佳的现状,相关领域诊疗专家有必要对CRW的诊疗方法进行系统性总结,并制订规范化诊疗指南。为此,中国医师协会骨科医师分会、中华医学会骨科学分会、中华医学会创伤学分会及中国医师协会急救复苏专业委员会创伤骨科与多发伤学组共同组织相关专家,依据需求牵引及循证医学的原则针对临床问题形成推荐意见,最终制订《创伤骨科慢性难愈性创面诊疗指南(2023版)》,从CRW的流行病学、诊断、治疗、术后管理、并发症预防与合并症管理及康复治疗与健康教育等方面提出9条推荐意见,为CRW的诊疗提供可靠的临床依据。Chronic refractory wound(CRW)is one of the most challengeable issues in clinic due to complex pathogenesis,long course of disease and poor prognosis.Experts need to conduct systematic summary for the diagnosis and treatment of CRW due to complex pathogenesis and poor prognosis,and standard guidelines for the diagnosis and treatment of CRW should be created.The Guideline for the diagnosis and treatment of chronic refractory wounds in orthopedic trauma patients(version 2023)was created by the expert group organized by the Chinese Association of Orthopedic Surgeons,Chinese Orthopedic Association,Chinese Society of Traumatology,and Trauma Orthopedics and Multiple Traumatology Group of Emergency Resuscitation Committee of Chinese Medical Doctor Association after the clinical problems were chosen based on demand-driven principles and principles of evidence-based medicine.The guideline systematically elaborated CRW from aspects of the epidemiology,diagnosis,treatment,postoperative management,complication prevention and comorbidity management,and rehabilitation and health education,and 9 recommendations were finally proposed to provide a reliable clinical reference for the diagnosis and treatment of CRW.

关 键 词：创伤和损伤 皮肤溃疡 伤口愈合 创面修复 

分 类 号：R687.3[医药卫生—骨科学]