To summarize the clinical characteristics of chronic skin ulcers and analyze the factors affecting the treatment effect, so as to improve the clinical diagnosis and treatment level.

A retrospective analysis was used to collect clinical data from 92 inpatients with chronic skin ulcers admitted to First Affiliated Hospital of Xinjiang Medical University from January 2018 to March 2021 who met the inclusion criteria. The general information of the patients were collected, such as gender, age, whether they have basic diseases and types, types of ulcers, and the location of ulcers, etc. Bacterial culture was carried out on the patient′s wound secretions to analyze the pathogenic bacteria detected on the wound surface; drug sensitivity tests were performed on the pathogenic bacteria detected on the wound surface to analyze the sensitivity of pathogenic bacteria to different antibiotics. Patients′ treatment modalities were counted, and the cure rates of different treatment modalities were calculated; the white blood cell count, neutrophil count, triglyceride and cholesterol values in patients′ blood were measured, and the relevant factors affecting the outcome of patients with chronic skin ulcers were analyzed. Data were compared by chi-square test and logistic regression analysis.

(1) Among the 92 inpatients with chronic skin ulcers, 46(50%) were male and 46 (50%) were female; the 55-70 years old patients were the most, accounting for 30.43%, followed by 40-54 years old, accounting for 29.35%, and the patients aged >70 years were the least, accounting for 17.39%; among the 92 patients, 67 patients had basic diseases that affected wound healing, and 32 of them had more than 2 basic diseases. (2) Among the 92 patients with chronic skin ulcers, malignant ulcers were the most common, accounting for 22.8%, followed by vascular ulcers, accounting for 21.7%, infectious ulcers and postoperative non-healing ulcers accounting for 15.2% respectively, and traumatic ulcers accounting for 9.8%; scar ulcers, pressure ulcers, and radiation ulcers accounted for smaller proportion, accounting for 6.5%, 5.4%, and 3.3%, respectively. (3)Among the 92 patients, the most common ulcer site was the lower extremity, including 17 cases (18.5%) of the ankle, 10 cases (10.9%) of the calf, and 3 cases (3.3%) of the thigh; the second and third sites for ulcers were the head, face and neck, chest, abdomen and back, accounting for 20.7% and 19.6%, with the remaining sites being relatively few, all accounting for less than 10.0%.(4) A total of 80 strains of pathogenic bacterial were detected, including 54 (67.5%) gram-positive bacteria and 26 (32.5%) gram-negative bacteria. The main detected gram-positive bacteria were Staphylococcus aureus (35.0%), Staphylococcus epidermidis (13.8%), and Enterococcus faecakis (7.5%); gram-negative bacteria were mainly Escherichia coli (7.5%) and Pseudomonas aeruginosa (6.3%). (5) According to the drug susceptibility test results, the resistance rate of Staphylococcus epidermidis to erythromycin was 100.0%, and the resistance rate to penicillin and clindamycin was 90.9%; Staphylococcus epidermidis was resistant to linezolid, vancomycin, rifampicin and tigecycline, and the sensitivity rates were 100.0%, 100.0%, 63.6%, and 63.6%; Staphylococcus aureus was 96.4% resistant to penicillin and 82.1% resistant to erythromycin; Staphylococcus aureus sensitive to linezolid, rifampicin, tigecycline, and vancomycin, the sensitivity rates were 89.3%, 85.7%, 85.7%, and 100.0%; Enterococcus faecium was sensitive to vancomycin, tigecycline, and the sensitivity rates were 83.3% and 83.3%, respectively; Escherichia coli was sensitive to cefotetan, meropenem, imipenem, piperacillin, and amikacin, and the sensitivity rates were 100.0%, 83.3%, 83.3%, 83.3%, and 83.3%. (6)Night-two patients were treated in three ways, 14 of them received non-surgical treatment and 78 received surgical treatment; among the patients who received surgical treatment, 42 were treated with surgical combined with negative pressure sealing drainage technique and 36 were treated with surgical treatment alone; the cure rates of patients who received surgical combined with negative pressure sealing drainage technique, surgical treatment alone and non-surgical treatment were 66.67%, 38.89% and 7.14%, respectively. There was a statistically significant difference in the cure rates of the three treatment methods (χ²=35.1, P<0.05), and the cure rate of patients receiving surgery combined with negative pressure sealing drainage technique was compared with that of patients treated with surgery alone and those treated without surgery, and the differences were statistically significant (χ²=6.0, 28.5; P<0.05). (7) Analysis of the factors affecting the outcome of patients with chronic skin ulcers showed that surgery combined with negative pressure sealing drainage technique and neutrophil count were independent factors affecting the outcome of patients with chronic skin ulcers.

For chronic skin ulcers, middle-aged and elderly people are the prone population, malignant ulcers are the most common cause, crus and ankle are the most important sites, Staphylococcus aureus is the most important bacterial infection, surgery combined with negative pressure sealing drainage technique has the best effect and better outcomes in patients with normal neutrophil counts.