To analyze the epidemiological characteristics of elderly patients with chronic refractory wound in plateau area, and analyze the impact of targeted treatment measures on the clinical prognosis.

A total of 106 elderly patients with chronic refractory wounds were selected from October 2019 to October 2020 in the Department of Burns and Plastic Surgery, Qinghai Provincial People′s Hospital. The general data of the patients were collected, including gender, age, residential area, and whether there were basic diseases; the causes of wound formation were analyzed; the proportion of patients with different wound formation sites was compared; and the detection of pathogenic bacteria on the wounds were analyzed. The effective rate, length of stay and medical expenses of patients with different treatment methods were investigated, and the clinical outcomes of patients with different ages were compared. Data were compared by one-way ANOVA, t test and chi-square test.

Among the elderly patients with chronic refractory wounds included in this study, 66.04% were male and 33.96% were female. The number of male patients was more than that of female patients. The number of patients aged 70 to 80 years old was the most, accounting for 44.34%, followed by 60 to 70 years old, accounting for 36.79%, and the number of patients over 80 years old was the least, accounting for 18.87%. Most of the patients come from urban areas, and most of them suffer from hypertension, diabetes, infection and other basic diseases. Etiological analysis showed that diabetic foot was the primary cause of elderly patients with chronic refractory wounds in plateau area, accounting for 51.9%, the second cause was pressure ulcer (17.9%), the third and the fourth cause were surgical wound infection (10.4%) and traumatic ulcer (9.4%), while venous and arterial ulcer accounted for the smallest proportion, accounting for 6.6% and 3.8% respectively; chronic refractory wounds were mainly located in the lower limbs, followed by lumbodorsal sacrococcygeal and upper limbs. A total of 106 strains of pathogenic bacteria were detected on the wound surface, most of which were Gram positive cocci, accounting for 61.32%, of which Staphylococcus aureus accounted for 42.45%, followed by Staphylococcus epidermidis (10.38%), other positive cocci accounted for less than 10.00%; 38 strains of gram negative bacilli were detected, accounting for 35.85%, of which Escherichia coli accounted for the most (11.32%), followed by Klebsiella pneumoniae, Enterobacter cloacae and Pseudomonas aeruginosa; 3 strains of fungi (2.83%) were found. There was a statistically significant difference in the treatment efficiency of patients with different treatment methods (χ²=9.602, P<0.05). The treatment efficiency of patients with surgery + supplementary treatment was significantly higher than that of patients with surgery alone, and the treatment efficiency of conservative + supplementary treatment was significant higher than that of patients received conservative treatment, the difference was statistically significant (χ²= 4.367, 3.876; P<0.05). The hospitalization time and medical expenses of patients with different treatment methods were statistically different (F=244.572, 457.531; P<0.05). The hospitalization time and medical expenses of patients with surgery + supplementary treatment were less than those of patients with surgery alone, the hospitalization time and medical expenses of conservative + supplementary treatment patients were less than those of conservative treatment patients, and the differences were statistically significant (t=9.938, 14.529, 4.237, 6.022; P<0.05). After treatment, the clinical outcomes of elderly patients with chronic refractory wounds of different ages were quite different. Among them, 60 to 70 years old has the highest effective rate (89.74%), compared with the 70-80 years old (78.72%), the difference was not statistically significant (χ²=1.899, P=0.168), and compared with the over 80 years old (65.00%), the difference was statistically significant (χ²=5.336, P=0.021). That is, with the increase of patients′ age, the worse the clinical outcome.

According to the epidemiological characteristics of elderly chronic refractory wounds in plateau areas, oxygen therapy and moisturizing treatment can effectively improve the prognosis of patients and reduce their medical costs. It is worthy of clinical application and promotion.