[Thoughts and principles of diagnosis and treatment of chronic refractory wounds in China].

The correct thoughts and principles of diagnosis and treatment of chronic refractory wounds need to be formulated. Through the relevant domestic and international consensus and based on clinical experience, the Thoughts and principles of diagnosis and treatment of chronic refractory wounds in China is proposed. It is considered that in the diagnosis and treatment of chronic refractory wounds, in the case of fully understanding the patient's medical history, the following thoughts and principles should be complied in order. (1) Pay attention to the cleanliness of the wound after being cleaned. (2) Reasonably perform debridement to avoid being " excessive" or " not thorough". (3) Reasonably perform examination, diagnosis, and differential diagnosis of pathogenic factors. (4) Treat according to etiology. (5) Find comorbidities and prevent adverse outcomes. (6) Select the correct wound treatment method reasonably and timely. When the conservative wound care treatment is considered, pay attention to embodying the concept of etiological treatment, treat the wound according to the principles of safety, phase, selectivity, and effectiveness, and make a reasonable choice of continuing conservative treatment or surgical treatment in time after completing the preparation of the wound bed. When surgical treatment is considered, pay attention to the selection of reasonable surgical method and donor site, pay attention to the healing rate of surgical wound site and the outcome of donor site, and give reasonable protection to the wound site after surgery. (7) Carry out rehabilitation treatment after wound healing and related health education.慢性难愈性创面疾病的诊疗需要树立正确的思路及原则。笔者通过相关国内、国际共识及基于临床经验总结，提出了《中国慢性难愈性创面诊疗思路及原则》。我们认为在慢性难愈性创面诊疗时，在充分了解患者病史的情况下，应按如下思路及原则顺序考虑。(1)注意创面经清洗后的清洁度。(2)合理清创，避免"过度"或"不彻底"。(3)合理进行致病原因的检查、诊断和鉴别诊断。(4)给予病因学治疗。(5)发现合并症并预防不良转归。(6)合理及时选择正确的创面治疗方法，考虑保守促愈时，注意体现病因学治疗理念，按安全性、时相性、选择性、有效性原则处理创面，在完成创面床准备后及时做出继续保守治疗或手术治疗的合理选择；考虑手术治疗时，注意选择合理手术方法、供区部位，注意观察手术创面愈合率和供区的转归，给予术后创面合理的保护。(7)给予创面愈合后的康复治疗及相关健康教育。.