What are the new advances in decubitus ulcer treatment?

  Decubitus ulcers are caused by a variety of illnesses that lead to limited mobility, prolonged bed rest, and localized pressure on the body, resulting in loss of nutrient supply to local tissues and loss of normal function, leading to ulceration and necrosis. They occur in the elderly, paraplegics, diabetics and others who are immunocompromised and weak, and can easily lead to systemic infections that are difficult to control and life-threatening, and are recognized as a difficult disease to treat.  Chen Shigong, an authentic Ming dynasty surgeon in Nantong, had effective prescriptions such as the “Yohong Paste”, “Centipede Preserves”, and “Pearl Powder”, as well as therapies such as simmering pus and growing flesh, decomposing muscle, wrapping method, nibbling method, and cotton pad method. Its method is respected by later generations and has been continuously developed. Nantong City Hospital of Traditional Chinese Medicine, adhering to the mantle of the authentic school of Chinese medicine in surgery, has many unique therapies and effective prescriptions for the treatment of difficult surgical conditions. The effective prescriptions for the treatment of decubitus ulcers, such as seahorse muscle plucking and toxin removal, decomposition and new cream, and dampness and itch relief agent powder, have created many miracles in the treatment of decubitus ulcers and are well known to many old Nantong people.  The development of modern technology must drive the development of medical technology, and so does Chinese medicine. Negative pressure drainage technology was introduced from Germany in recent years. It is through the uninterrupted drainage, timely, thorough, all-round exclusion of wound exudate, pus and shedding necrotic tissue, creating a “zero accumulation” including drainage channels were drained area. Compared with the traditional single drug exchange treatment, it not only changes open wounds into closed wounds, but also provides comprehensive and continuous drainage, removes liquefied tissues and various toxic decomposition products, and stimulates granulation growth, which is a metabolic function that exceeds that of its own skin and soft tissue cover, making it ideal for decubitus ulcer patients.  Traditional Chinese medicine and negative pressure drainage techniques have their own therapeutic advantages and can complement each other by playing to their strengths at different stages of decubitus ulcer treatment. Negative pressure drainage can be used to control infection, suppress inflammation, and promote the growth of granulation in a relatively short period of time. After the sore surface granulation is fresh and red, the choice of topical Chinese medicine to continue the treatment can effectively promote the final healing of the wound. In this process, the two methods can also be used alternately for better results depending on the situation. For some patients with large sores, the above preparations can be used to perform flap transfer or skin grafting when the systemic and local conditions are ripe, which can be done in a short time.  For example, Sun Lianying, an old woman who was nearly 90 years old, was bedridden for a long time and had a deep decubitus ulcer in her caudal sacral region that rotted to her sacrum and affected her whole body. After she came to our ulcer specialist, she was completely cured by negative pressure drainage, herbal medicine exchange, and finally skin implantation, and her general condition was completely restored. Gao Jie, aged 38, who lived in Xiaohai, was paraplegic and bedridden for a long time due to an accident ten years ago. The bed sores on his buttocks were repeatedly ulcerated, and he could not be cured by various treatments. When he came to our hospital for treatment, he had a high fever of 40 degrees, and his hip decubitus ulcer was larger than 20 cm in diameter and deeper than the lumbar vertebrae, sacrum and left hip joint, with pus dripping and fishy smell, and the infection was very serious. Gao Jie himself had lost his confidence to continue living and wanted to give up treatment and go home to wait for death. According to past experience, such cases are really difficult to cure, and bed sores are one of the main causes of death for such patients. However, we used the method of multiple debridement, negative pressure drainage, herbal medicine change and finally flap transfer to cure him completely, which was reported by Nantong TV.  Since 2007, we have creatively combined negative pressure drainage technology with traditional Chinese medicine in the treatment of decubitus ulcer patients, and obtained satisfactory results. By now, we have treated nearly 100 cases, with an efficiency rate of 100% and a healing rate of 95%. The papers published were exchanged at the National Conference on Sore Surgery and received recognition. The treatment of decubitus ulcers has become a major feature of the Chinese medicine surgery department of our hospital.  The combination of ancient treatment and modern technology has greatly shortened the treatment time for decubitus ulcers, reduced the comprehensive cost and alleviated the pain of patients, and has achieved the perfect effect of getting twice the result with half the effort. It is an exemplary combination of Chinese medicine and modern technology, and has created a new era for the treatment of decubitus ulcers.