Wound infection can prolong wound healing time, increase hospitalization cycle and readmission rate, seriously affect patients’ quality of life and increase economic expenditure. Timely and accurate identification and management of wound infections is key to promoting wound healing and maximizing cost-effective management. In 2022, the International Wound Infection Association published the third edition of Wound Infection in Clinical Practice: Principles of Best Practice. The consensus incorporates new advances in research and clinical practice in the areas of wound environment, risk factors for infection, biofilms, antibiotic resistance, and the identification and management of wound infections, and provides detailed approaches to infection assessment and management. This article introduces the key elements of the 2022 expert consensus and interprets the updated content to help healthcare professionals, patients, caregivers, and policy makers understand the latest consensus document, promote its clinical application in the prevention and treatment of wound infection, and better improve the quality of clinical practice.
This article interprets the core updated content of WHS Guidelines for the Treatment of Pressure Ulcers-2023 update compared to Wound Healing Society 2015 update on Guidelines for Pressure Ulcers in multiple key areas, including posture and support surface, infection, wound bed preparation, surgical treatment, and adjuvant therapy. Additionally, the article deeply interprets the new content of the 2023 updated guidelines (palliative wound care for patients with severe pressure ulcers), in order to provide efficient and convenient reference tools for domestic medical personnel to quickly grasp the latest developments in pressure ulcer treatment, standardize treatment processes, and improve treatment effectiveness.
Objective To summarize the cl inical experience of vascular bypass grafting combined with endovascularaortic repair (EVAR) for aortic dilatation disease. Methods Between January 2008 and August 2011, 12 patients with aorticdilatation disease were treated with vascular bypass grafting combined with EVAR. Of 12 patients, 11 were male and 1 wasfemale, aged 47-81 years (mean, 65.9 years). All cases were diagnosed through computed tomography angiography (CTA),including 1 case of Stanford type A dissection, 5 cases of Stanford type B dissection, 4 cases of aortic arch aneurysm, and 2 casesof abdominal aortic aneurysm. Eight patients received neck artery bypass grafting before EVAR, and 4 patients underwentfemoral artery bypass grafting after EVAR. Results After operation, pulmonary infection occurred in 3 patients, renalinsufficiency in 2 patients, cerebral infarction in 1 case, decreased hemoglobin and platelets in 7 cases, and poor healing of groinwound in 1 case. Eleven patients were followed up 3-42 months, with an average of 18.6 months. In 1 case undergoing EVARof the thoracic and abdominal aorta, EVAR was performed again because new aneurysms formed at 6 months after operation,and the patient achieved good recovery after 3 months. CTA showed reduced false lumen, thrombosis formation, no endoleak,no deformation or displacement of stent, and anastomotic patency of artificial blood vessels in the other patients at 3, 6, and12 months after operation. Conclusion Vascular bypass grafting combined with EVAR can expand the indications forendovascular repair. It not only provides sufficient anchoring area, but also ensures the blood supply to vital organs, simplifiesthe surgical procedure, and reduces the difficulty of endovascular treatment.
ObjectiveTo evaluate the safety, feasibility, and short-term surgical outcomes of a modified right vertical infra-axillary thoracotomy (MRVIAT, single 2-5 cm incision without peripheral cannulation) for the treatment of doubly committed subarterial ventricular septal defect in patients of all ages, and to summarize relevant surgical techniques. MethodsThis study retrospectively included patients of all ages with doubly committed subarterial ventricular septal defect who underwent surgical repair via MRVIAT from January 2022 to June 2025, all receiving a single 2-5 cm incision without peripheral cardiopulmonary bypass. The perioperative and follow-up data were analyzed. ResultsA total of 241 patients were enrolled, comprising 92 males and 149 females with a median age of 1.2 (0.5, 3.5) years [including 11 (4.6%) patients aged ≥18 years] and a median weight of 10.5 (7.0, 16.4) kg. Preoperative left ventricular ejection fraction was 66.9%±4.2%, and the mean defect size was (7.6±2.8) mm. All surgeries were successfully completed without conversion to median sternotomy or in-hospital mortality. Cardiopulmonary bypass time was (55.4±13.3) min, aortic cross-clamping time was (34.8±10.1) min, postoperative hospital stay was (6.5±1.9) d, ventilation time was (6.5±6.1) h, intensive care unit stay was (39.7±24.1) h, and postoperative left ventricular ejection fraction was 67.8%±7.6%. Postoperative complications included mild residual shunt in 3 (1.2%) patients, incision infection in 2 (0.8%) patients, and pulmonary infection in 1 (0.4%) patient. The median follow-up time was 1.7 years (range, 0.3-3.5 years), during which no surgery-related chest deformities or moderate-to-severe valvular regurgitation were observed. ConclusionThe MRVIAT is safe and feasible for treating doubly committed subarterial ventricular septal defect in patients of all ages, offering a smaller and more concealed incision without the need for peripheral cardiopulmonary cannulation, and may be considered an alternative to median sternotomy.