Application of multi-disciplinary team model led by enterostomal therapist in the diagnosis and treatment of chronic wounds_West China Medical Journal

Authors：

SHI Yulan , YU Jingya , XIANG Lijuan , CHEN Cheng , LI Lu ,  DAI Yan ,  ZHAO Shuzhen

Outpatient Department, West China Hospital, Sichuan University / West China School of Nursing, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

DAI Yan, Email: 1846703501@qq.com; ZHAO Shuzhen, Email: sssZsZZsz@126.com

Keywords：

Enterostomal therapist; multi-disciplinary team; chronic wound; effect

DOI：

10.7507/1002-0179.202304084

Video：

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Objective To explore the clinical practice effects of multi-disciplinary team (MDT) model led by enterostomal therapist in the diagnosis and treatment of chronic wounds. Methods Three types of subspecialty patients diagnosed and treated by the MDT team for chronic wounds in the Wound Care Center of West China Hospital of Sichuan University between January 2020 and December 2022, including MDT for diabetes feet, MDT for immune ulcer and MDT for other refractory wounds, were retrospectively included. The clinical data, healing rate, healing time, and satisfaction rate of patients were analyzed. Results A total of 176 patients were included, including 103 cases of diabetes foot, 31 cases of immune ulcer, and 42 cases of other refractory wounds. The healing rate was 71.84% in patients with MDT of diabetes foot, 74.19% in patients with MDT of immune ulcer and 78.57% in patients with MDT of other refractory wound. The average healing time was 18.10 weeks for patients with diabetes foot, 19.69 weeks for patients with immune ulcer, and 20.53 weeks for patients with other refractory wounds. The satisfaction rates of patients in the three groups were relatively high (>95%). Conclusion The MDT model led by enterostomal therapist can provide comprehensive treatment plans for difficult and complex chronic wound patients, improve the treatment outcomes of chronic wounds, and is worthy of further promotion and application in the clinical diagnosis and treatment of chronic wounds.

Citation： SHI Yulan, YU Jingya, XIANG Lijuan, CHEN Cheng, LI Lu, DAI Yan, ZHAO Shuzhen. Application of multi-disciplinary team model led by enterostomal therapist in the diagnosis and treatment of chronic wounds. West China Medical Journal, 2024, 39(1): 17-21. doi: 10.7507/1002-0179.202304084 Copy

1.	Nussbaum SR, Carter MJ, Fife CE, et al. An economic evaluation of the impact, cost, and medicare policy implications of chronic nonhealing wounds. Value Health, 2018, 21(1): 27-32.
2.	冉興無, 許樟榮. 以創新促發展, 應對日益增多的難治性糖尿病足潰瘍. 四川大學學報(醫學版), 2022, 53(6): 945-948.
3.	張紀蔚, 張柏根. 下肢難治性靜脈潰瘍. 中國實用外科雜志, 2001, 21(5): 269-271.
4.	封紅偉, 陳麗琴, 胡繡華, 等. 專科護士為主導多學科慢性傷口護理團隊的建立與實踐. 國際護理學雜志, 2020, 39(13): 2312-2315.
5.	Garcia AN, Costa LDCM, Hancock MJ, et al. McKenzie method of mechanical diagnosis and therapy was slightly more effective than placebo for pain, but not for disability, in patients with chronic non-specific low back pain: a randomised placebo controlled trial with short and longer term follow-up. Br J Sports Med, 2018, 52(9): 594-600.
6.	張海濱, 史海娜, 王旭東. MDT 診療模式救治急診危重批量傷患者的臨床應用. 中國急救復蘇與災害醫學雜志, 2018, 13(3): 231-233.
7.	楊愛花, 嚴梅, 秦亞輝. 國內外造口專科護理發展現狀. 護理研究, 2016(1): 4-7.
8.	魏在榮, 黃廣濤. 慢性創面的治療進展及創面外科整合治療模式探討. 中華燒傷雜志, 2019, 35(11): 824-827.
9.	吳弟群, 羅孟媛, 陳旭, 等. 多學科合作對人工氣道患者肺部感染發生率的影響研究. 齊魯護理雜志, 2019, 25(19): 51-53.
10.	魏群英, 羅彩紅, 竇夢. 多學科團隊協作模式在急性腦外傷手術患者中的應用. 齊魯護理雜志, 2021, 27(4): 80-82.
11.	馬輝. 造口治療師(ET)在多學科協作治療(MDT)中的臨床實踐進展. 結直腸肛門外科, 2020, 26(2): 247-250.
12.	馮玉婕, 陳麒麟, 封秀萍, 等. 專職護理人員在提升多學科綜合門診診療服務中的作用. 齊魯護理雜志, 2021, 27(7): 88-90.
13.	Albright RH, Manohar NB, Murillo JF, et al. Effectiveness of multidisciplinary care teams in reducing major amputation rate in adults with diabetes: a systematic review & meta-analysis. Diabetes Res Clin Pract, 2020, 161: 107996.
14.	Joret MO, Osman K, Dean A, et al. Multidisciplinary clinics reduce treatment costs and improve patient outcomes in diabetic foot disease. J Vasc Surg, 2019, 70(3): 806-814.
15.	蔣琪霞, 周濟宏, 錢洪波, 等. 跨學科團隊合作處理復雜傷口的實踐與效果. 中國護理管理, 2018, 18(1): 10-14.
16.	Fournier C, Singbo N, Morissette N, et al. Outcomes of diabetic foot ulcers in a tertiary referral interdisciplinary clinic: a retrospective canadian study. Can J Diabetes, 2021, 45(3): 255-260.
17.	Shanmugam VK, Angra D, Rahimi H, et al. Vasculitic and autoimmune wounds. J Vasc Surg Venous Lymphat Disord, 2017, 5(2): 280-292.
18.	吳莉萍, 張子云, 婁雪嬌, 等. 風濕免疫疾病患者皮膚潰瘍的多學科協作綜合護理. 護理學雜志, 2022, 37(16): 38-40.
19.	余瑾, 黃站梅, 吳銳, 等. 威伐光促進免疫性潰瘍愈合的護理研究. 中國當代醫藥, 2020, 27(33): 204-206,214.
20.	孫紅, 黃漢偉, 曾茹英, 等. 慢性傷口治療護理團隊合作模式的建立與效果評價. 海南醫學, 2016, 27(8): 1365-1366.
21.	李利英, 于倩. MDT 模式在慢性傷口患者管理中的臨床效果分析. 健康大視野, 2020(17): 276.

1. Nussbaum SR, Carter MJ, Fife CE, et al. An economic evaluation of the impact, cost, and medicare policy implications of chronic nonhealing wounds. Value Health, 2018, 21(1): 27-32.
2. 冉興無, 許樟榮. 以創新促發展, 應對日益增多的難治性糖尿病足潰瘍. 四川大學學報(醫學版), 2022, 53(6): 945-948.
3. 張紀蔚, 張柏根. 下肢難治性靜脈潰瘍. 中國實用外科雜志, 2001, 21(5): 269-271.
4. 封紅偉, 陳麗琴, 胡繡華, 等. 專科護士為主導多學科慢性傷口護理團隊的建立與實踐. 國際護理學雜志, 2020, 39(13): 2312-2315.
5. Garcia AN, Costa LDCM, Hancock MJ, et al. McKenzie method of mechanical diagnosis and therapy was slightly more effective than placebo for pain, but not for disability, in patients with chronic non-specific low back pain: a randomised placebo controlled trial with short and longer term follow-up. Br J Sports Med, 2018, 52(9): 594-600.
6. 張海濱, 史海娜, 王旭東. MDT 診療模式救治急診危重批量傷患者的臨床應用. 中國急救復蘇與災害醫學雜志, 2018, 13(3): 231-233.
7. 楊愛花, 嚴梅, 秦亞輝. 國內外造口專科護理發展現狀. 護理研究, 2016(1): 4-7.
8. 魏在榮, 黃廣濤. 慢性創面的治療進展及創面外科整合治療模式探討. 中華燒傷雜志, 2019, 35(11): 824-827.
9. 吳弟群, 羅孟媛, 陳旭, 等. 多學科合作對人工氣道患者肺部感染發生率的影響研究. 齊魯護理雜志, 2019, 25(19): 51-53.
10. 魏群英, 羅彩紅, 竇夢. 多學科團隊協作模式在急性腦外傷手術患者中的應用. 齊魯護理雜志, 2021, 27(4): 80-82.
11. 馬輝. 造口治療師(ET)在多學科協作治療(MDT)中的臨床實踐進展. 結直腸肛門外科, 2020, 26(2): 247-250.
12. 馮玉婕, 陳麒麟, 封秀萍, 等. 專職護理人員在提升多學科綜合門診診療服務中的作用. 齊魯護理雜志, 2021, 27(7): 88-90.
13. Albright RH, Manohar NB, Murillo JF, et al. Effectiveness of multidisciplinary care teams in reducing major amputation rate in adults with diabetes: a systematic review & meta-analysis. Diabetes Res Clin Pract, 2020, 161: 107996.
14. Joret MO, Osman K, Dean A, et al. Multidisciplinary clinics reduce treatment costs and improve patient outcomes in diabetic foot disease. J Vasc Surg, 2019, 70(3): 806-814.
15. 蔣琪霞, 周濟宏, 錢洪波, 等. 跨學科團隊合作處理復雜傷口的實踐與效果. 中國護理管理, 2018, 18(1): 10-14.
16. Fournier C, Singbo N, Morissette N, et al. Outcomes of diabetic foot ulcers in a tertiary referral interdisciplinary clinic: a retrospective canadian study. Can J Diabetes, 2021, 45(3): 255-260.
17. Shanmugam VK, Angra D, Rahimi H, et al. Vasculitic and autoimmune wounds. J Vasc Surg Venous Lymphat Disord, 2017, 5(2): 280-292.
18. 吳莉萍, 張子云, 婁雪嬌, 等. 風濕免疫疾病患者皮膚潰瘍的多學科協作綜合護理. 護理學雜志, 2022, 37(16): 38-40.
19. 余瑾, 黃站梅, 吳銳, 等. 威伐光促進免疫性潰瘍愈合的護理研究. 中國當代醫藥, 2020, 27(33): 204-206,214.
20. 孫紅, 黃漢偉, 曾茹英, 等. 慢性傷口治療護理團隊合作模式的建立與效果評價. 海南醫學, 2016, 27(8): 1365-1366.
21. 李利英, 于倩. MDT 模式在慢性傷口患者管理中的臨床效果分析. 健康大視野, 2020(17): 276.

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Application of multi-disciplinary team model led by enterostomal therapist in the diagnosis and treatment of chronic wounds

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