Objective: To survey the condition of bacteria on the scar area; to improve the method and outcome of skin with scar prepared for plastic surgery. Methods: 49 patients were divided into group A and B randomly. 24 patients in group A were enrolled in control group and 25 patients in group B were designed for investigation group. Each scar was taken 3 samples to be cultured and submitted for sensitive test on admission day, before and after the skin with scar prepared. Each case was observed on the types and the condition of bacteria distribution on the scar. The outcome of cleaning and disinfection from the area was recorded. The relationship between the bacteria reproduction and types of scar was analyzed, and the observation of the postoperative temperature was made and the duration of antibiotics used and surgical site healing were recorded. Results: The positive rate of bacterial culture was reached 83.33% -88.00%. Two methods of skin prepared can diminish the bacteria reproduction. The outcomes of Group B was better than Group A. The temperature and wound healing days had no significant difference between the two groups. The days used of antibiotics in group B were significantly shorter than group A. Conclusion: The more effective method can improve the clean ingress of the skin than with usual method. 60% bacteria on the area removed was benefit to prevent wound infection and healing.

It is becoming a new trend in wound care field to do quantitative evaluation for the effect of wounds.The pressure ulcer scale for healing (PUSH) made by national pressure ulcer advisory panel (NPUAP) was used to evaluate the effect of pressure ulcers quantitatively at first and then it was used to different classification wounds.This article reviews the advancement of validity and reliability of PUSH in inter-professional research and clinical application in order to provide reference data for correctly using the tool.

Objective Mechanical ventilation is an important life support treatment in ICU, however, patients are at high risk for ventilator?associated pneumonia(VAP) and other complications which can increase the risk of death. In the article, comparative investigation was made on ventilation effects of different degrees of semirecumbent positions and preventive effects of VAP and pressure ulcers in order to provide evidence for preferred position. Methods 46 patients were divided into 30° group and 45° group in halves according to the angle of semirecumbent position. Patient position changes were performed among semirecumbent, right and left laterally inclined positions every two hours in both groups for consecutive 7 days. The peak airway pressure (PAP) and minute ventilation (MV) changes were measured every half an hour in two hours after semire?cumbent positioning every day during ventilation. The pressure of arte?rial oxygen(PaO2), pressure of arterial carbenoxide (PaCO2) and PaO2/FiO2(fraction of inspired oxygen,FiO2) were tested every day during intervention, along with the observation on the incidence of VAP and pressure ulcers. Results MV at each time point was normal in two hours after semirecumbent positioning in both groups with no changes to prolonged time ( P<0.05) . PAP increased with the prolonged time at each time point, which was higher in 45° group compared with 30°group(P<0.05). No significant difference was found in the incidence of VAP and pressure ulcers between two groups (P>0.05). Conclusion Both 45° and 30°semirecumbent po?sitions can be applied in ventilated patients and the patient′s medical condition and tolerance are the keys when choosing preferred posi?tion and duration.

The infection of chronic refractory wound is related with bacterial biofilm .How to prevent and treat bacterial bio-film and its related damage has been a hot topic in current studies .This article provides a review on chronic wound biofilm on clinical diagnosis techniques , diagnostic criteria , bacteria identification outcomes and influencing factors .

Objective To explore the methods and effects of specialty training for wound care. Methods Fourteen nurses working and studying in the wound care center received specialty training of wound care. Their current knowledge and train-ing needs were assessed through writing test and symposium before the training. Then,the training contents and plan were de-signed. The training duration was identified as 3-6 months. The open teaching method was applied in the training directed by the entrostomal therapists(ET). According to the evaluation index,the nurses were asked to finish a reading report in the first month,a case report in the second month,and group discussion on a case of complicated wound care the third month. In ad-dition,they needed to finish the exam of wound care theory and skills every three months. The correlations between perfor-mance in the examination and the nurses' age,years of working experlence,educational level,professional title,duration and times of training by correlation analysis. Results The times of training was significantly correlated with the performance in the examination(r=-0.49,P<0.05),especially with the performance of case report,reading report,and group discussion on compli-cated wound care(r=0.51,-0.60,P<0.05). There was no correlation between the performance with nurses' age,years of working experience,educational level,professional title and duration of training. Conclusion One time of specialty training at least 3 months can achieve good effect. The times of training is correlated with the training effect,especially in case report,reading report and group discussion on complicated wound care.

Objective Nutrition becomes a focus to professionals as an important factor during the development of pressure ulcers.However, there is no evidence for the effectiveness of eternal nutrition support for pressure ulcer prevention .This research aimed to evaluate the effectiveness of eternal nutrition support for pressure ulcer prevention and provide evidence for patients with the risk of pressure ulcer . Methods Key words such as pressure ulcer prevention,eternal nutritional supportwere used to search information in the Cochrane Library , JBI Database of Systematic Reviews , MEDLINE, Web of Science, EMbase, CBMdisc, CNKI and Wanfang Database to collect randomized controlled trials (RCTs).The quality of RCTs was critically appraised and data were extracted by 3 reviewers independently .Meta-analyses were conducted for the eligible RCTs using RevMan 5.0 software, and Stata12.0 software was applied to detect bias or sensitivity analysis to determine the source of heterogeneity if necessary . Results 7 RCTs were includ-ed, among which 1 RCT was excluded by sensitivity analysis .6 RCTs ( n=1553 ) were finally included for meta analysis ( n=728 in trail group, n=825 in control group), and all the patients were given oral nutrition support for 7days to 26 weeks.The results showed that the ulcer incidence in the intervention group reduced by 16%in comparison to the control group (P=0.006).The protein and energy intake in intervention group were higher than those in control group , and the length of stay in hospital was shortened by 16 days. No significant difference was found in the albumin values . Conclusion The enteric nutrition support can reduce the incidence of pressure ulcer obviously with the highest level of evidence , IA .

Objective Medical ethical problems have become underlying risks since the introduce of Negative pressure wound therapy ( NPWT) in Wound Care Center .The article was to analyze ethical problems in applying new technology in wound care and take intervention countermeasures to investigate the effects . Methods Patients treated by NPWT from January 2009 to Decem-ber 2012 were collected as objectives of investigation from the indexes of compliance rate , cure rate and adverse event rate .The ethical problems related to efficacy ,safety and conflicts of patients′economic interests during the application of NPWT were analyzed .On the basis of the ethnical core principle which was harmless , beneficial, respectful and justifiable , the details of effectiveness and safety of NPWT technique , informed consent form and emergency response protocols of the adverse events were designed according to interna -tional guidelines .Nurses received standardized training to learn new technology . Results 78 cases with chronic wounds accepted negative pressure wound therapy and all cooperated to complete treatment , compliance rate was 100%, no adverse events , the average cure rate was 91 .03%.The treatment costs are less than international and national costs from 75%to 66%. Conclusion Following the ethical principle , informed consent , good communication , strict entry system and standardized operation process make sure the safety and effectiveness of new technology and optimize patients′benefits .

Objective: To explore the way of innovation and development of the pattern and means in nursing management in military hospital.Methods:Through various innovative practice from the following aspects,such as nursing service philosophy and measures for soldiers,the methods of nursing management and the elite-cultivating,nursing security management,which demonstrates the availability of innovation and development of the pattern and means in nursing management in military hospital.Results:The satisfactory rate of nursing service reached up to 99% in the examination of serving for soldiers of the whole army.The instruments which are manufactured for battle-scarred wounds and injuries use the flat of the Wound Nursing Centre,have reached the stage of clinical trial,we have completed five items of serial nursing research.The control rate of nursing quality of the whole hospital increased from 93.12% in 2003 to 98.9% in 2006,the satisfactory ratio of serious in-patient increased from 90.2% in 2003 to 96.7% in 2005.The ratio of health education achieves 100%.The satisfactory ratio of in-patient was 98.4% in September 2005,compared with 89.3% in February 2004.Conclusion:Only innovation can make nursing management develop and improve in military hospital.

Objective: To study the effect of moist therapy on dermal radio lesions. Methods:13 located dermal radio lesions about Ⅲ-Ⅳ stage from 12 cases were treated with moist therapy. Wound managing steps for each time: The first step was to measure the size of wounds and take photos, and then evaluate individual pain level by a numeric pain scale. The second step was to assess and analyze the factors affecting wounds healing, including nutrition, sleeping, activity, psychological condition. After that the individualized plans about nutrition, activity, and psychological care were made. While exchanging dressings, the implementation and effects of the plans must be evaluated and adjusted. The mechanical debridement combined with autolyzing debridement was used for wounds managing. Then the wounds were saturated with bFGF and normal saline, and wetly covered with occlusive dressings. Wounds were managed every two days until wounds healed. Results: All 13 wounds were cured. The average healing time was (10?6)d and the average cost was (202?48)yuan. The pain level after moist therapy was significantly lowered than before(P

Objective:Pyoderma gangrenosum(PG) is regarded as a possibly immunity-mediated ulcerative skin disease,which is difficult to be managed and easy to relapse.Few cases of PG have been reported to be treated successfully in the world.This study aimed to investigate the clinical characteristics and difficulties and strategies in the management of mosquito bite-induced ulcer by PG.Methods: We analyzed the clinical characteristics and difficulties in the treatment of a case of mosquito bite-induced leg ulcer complicated by PG.Following the TIME(tissue removal,infection/inflammation control,moisture imbalance correction,and edge of wound revision) principles of wound bed preparation,we treated the ulcer by silver ion dressing + infrared rays,hypertonic saline dressing + infrared rays,hypertonic saline dressing + electrotherapy,and honey dressing + medication at different times.The ulcer size and scores on pain and healing were assessed before each wound care,and the results of each method were analyzed by the SPSS11.0 software.Results: The pain score was continuously reduced with the treatment and the ulcer size and healing score were gradually decreased in the later stage,while in the earlier stage,the ulcer size was even enlarged,with one ulcer becoming two,and the healing score obviously increased.The differences were statistically significant(P