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 forthe 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.

Objective To investigate whether hyperbaric oxygen preconditioning (HBOP) could decrease the incidence of postoperative complications in patients with distal tibiofibular fracture.Methods Two hundred and eighty-seven cases of distal tibiofibular open fracture admitted into the Zhongshan Hospital Affiliated to Fudan University for treatment from January 2004 to March 2013 were randomly divided into 2 groups:the hyperbaric oxygen preconditioning (HBOP) group(n =149)and the control group(n =138).On the basis of routine therapy prior to internal fixation,the HBOP group was administered with HBO therapy,while the control group was left there without HBO therapy.All the patents had 12-26 months of medical follow-ups to assess the results of different treatment.Then,the incidence of postoperative complications and functional recovery level were compared between the 2 groups.Results The incidence of postoperative complications in the HBOP group was obviously lower than that in the control group (P ＜ 0.05).And functional recovery level in the patients of the HBOP group was significantly superior to that of the control group,and statistical significance could be noted,when comparisons were made between the 2 groups (P ＜ O.05).Conclusions HBO preconditioning before surgical treatment of the patients with distal tibiofibular fracture could effectively decrease the incidence of postoperative complications and improve their functional recovery level.

Objective To investigate whether hyperbaric oxygen preconditioning (HBOP) could decrease the incidence of postoperative complications in patients with distal tibiofibular fracture.Methods Two hundred and eighty-seven cases of distal tibiofibular open fracture admitted into the Zhongshan Hospital Affiliated to Fudan University for treatment from January 2004 to March 2013 were randomly divided into 2 groups:the hyperbaric oxygen preconditioning (HBOP) group(n =149)and the control group(n =138).On the basis of routine therapy prior to internal fixation,the HBOP group was administered with HBO therapy,while the control group was left there without HBO therapy.All the patents had 12-26 months of medical follow-ups to assess the results of different treatment.Then,the incidence of postoperative complications and functional recovery level were compared between the 2 groups.Results The incidence of postoperative complications in the HBOP group was obviously lower than that in the control group (P ＜ 0.05).And functional recovery level in the patients of the HBOP group was significantly superior to that of the control group,and statistical significance could be noted,when comparisons were made between the 2 groups (P ＜ O.05).Conclusions HBO preconditioning before surgical treatment of the patients with distal tibiofibular fracture could effectively decrease the incidence of postoperative complications and improve their functional recovery level.