Retrospective analysis of hospitalized cases in wound repair center from a tertiary hospital at Beijing in 2017

Abstract

Objective To retrospectively investigate the epidemiological characteristics and related medical information of hospitalized cases of skin and soft tissue injury in wound repair center from a tertiary hospital in Beijing. Methods All data of hospitalized cases from January 1, 2017 to December 31 in the Department of Burns and Plastic Surgery, Wound Repair Center, Fourth Medical Center of Chinese PLA General Hospital were collected and analyzed. The information included patients basic data, wound types, locations and microbiology information, therapies, outcomes, and health economics information. The epidemiological features of hospitalized patients was described, and the effects of gender, course of wound, wound type, treatment on wound infection, curative effects, hospitalization time and hospitalization expenses were compared. Data were processed with one-way analysis of variance, Wilcoxon rank test, Kruskal-Wallis H test, chi-square test and H test. Results Six hundred and thirty-nine patients were finally included in this study, including 420 males and 219 females. (1) The mean age of patients was 57.00 (43.00-67.00) years old, the mean age of female was greater than that of male, the difference was statistically significant (Z=-2.605, P<0, 05). (2) Two hundred and ninty patients with chronic basic diseases, the most common diseases were diabetes mellitus, hypertension, coronary atherosclerotic heart disease. (3) The number of patients with chronic skin and soft tissue injuries was more than acute skin and soft tissue injuries. (4) The most common causes were postoperative non-healing wounds, diabetic foot ulcer, pressure injury and soft tissue infections, the most common locations were the feet, lower extremities and chests. (5) Bacterial examination of the wound showed Gram-negative bacteria composition ratio was the highest (57.61%). Common bacteria were Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, Pseudomonas aeruginosa. (6) One hundred and thirty-six patients underwent simple dressing treatment, 118 underwent simple continuous negative pressure drainage, and 385 underwent surgical treatment, of which 130 underwent multiple surgical treatments. Two hundred and eighty-two patients were cured, 313 improved, 39 not healed, and 5 people dead. (7) The average hospitalization expense was 34, 354.15 (16 449.72-75 018.24) yuan. The average length of hospital stay was 21.00 (11.00-40.00) days. According to the wound types, the hospitalization expense and day of immune-mediated skin ulcer were the highest, and the hospitalization expense and day of hypertrophic scar were the lowest. According to the cost types, the hospitalization expense and day of patients with employment injury insurance are the highest, and the hospitalization expense and day of self-paying patients were the lowest. Conclusion Most of the patients are middle-aged and older, and with chronic basic diseases. The main course of the disease is chronic skin and soft tissue injury. The common causes are postoperative non-healing wounds, diabetic foot ulcer, pressure injuries and soft tissue infections. The sites are concentrated in the feet, lower limbs and chests. The proportion of Gram-negative bacteria infection is higher, which showes that it is necessary to strengthen the antibiotic treatment of such microbiology. Surgical debridement, continuous negative pressure drainage are effective measures for the treatment of patients with skin and soft tissue injury. Key words: Soft tissue injuries; Infection; Wound Healing; Epidemiology; Inpatients; Analysis