RESUMEN
"Wound, pressure ulcer and burn guidelines - 6: Guidelines for the management of burns, second edition" is revised from the first edition which was published in the Japanese Journal of Dermatology in 2016. The guidelines were drafted by the Wound, Pressure Ulcer and Burn Guidelines Drafting Committee delegated by the Japanese Dermatological Association, and intend to facilitate physicians' clinical decisions in preventing, diagnosing and treating burn injury. All sections are updated by collecting documents published since the publication of the first edition. Especially, the recommendation levels of dressing materials newly covered by the Japanese national health insurance are mentioned. In addition, the clinical questions (CQ) regarding the initial treatment of electrical (CQ15) and chemical burns (CQ16), and also the use of escharotomy (CQ22), are newly created.
Asunto(s)
Úlcera por Presión , Vendajes , Humanos , Úlcera por Presión/diagnóstico , Úlcera por Presión/terapiaRESUMEN
The Japanese Dermatological Association prepared the clinical guidelines for the "Wound, pressure ulcer and burn guidelines", second edition, focusing on treatments. Among them, "Guidelines for wounds in general" is intended to provide the knowledge necessary to heal wounds, without focusing on particular disorders. It informs the basic principles of wound treatment, before explanations are provided in individual chapters of the guidelines. We updated all sections by collecting references published since the publication of the first edition. In particular, we included new wound dressings and topical medications. Additionally, we added "Question 6: How should wound-related pain be considered, and what should be done to control it?" as a new section addressing wound pain, which was not included in the first edition.
Asunto(s)
Úlcera por Presión , Vendajes , Humanos , Úlcera por Presión/terapia , Cicatrización de HeridasRESUMEN
The Japanese Dermatological Association prepared guidelines focused on the treatment of skin ulcers associated with connective tissue disease/vasculitis practical in clinical settings of dermatological care. Skin ulcers associated with connective tissue diseases or vasculitis occur on the background of a wide variety of diseases including, typically, systemic sclerosis but also systemic lupus erythematosus (SLE), dermatomyositis, rheumatoid arthritis (RA), various vasculitides and antiphospholipid antibody syndrome (APS). Therefore, in preparing the present guidelines, we considered diagnostic/therapeutic approaches appropriate for each of these disorders to be necessary and developed algorithms and clinical questions for systemic sclerosis, SLE, dermatomyositis, RA, vasculitis and APS.
Asunto(s)
Enfermedades del Tejido Conjuntivo , Lupus Eritematoso Sistémico , Úlcera por Presión , Enfermedades Cutáneas Vasculares , Úlcera Cutánea , Vasculitis , Humanos , Úlcera Cutánea/diagnóstico , Úlcera Cutánea/tratamiento farmacológico , Úlcera Cutánea/etiología , Vasculitis/diagnóstico , Vasculitis/tratamiento farmacológicoRESUMEN
Burns are a common type of skin injury encountered at all levels of medical facilities from private clinics to core hospitals. Minor burns heal by topical treatment alone, but moderate to severe burns require systemic management, and skin grafting is often necessary also for topical treatment. Inappropriate initial treatment or delay of initial treatment may exert adverse effects on the subsequent treatment and course. Therefore, accurate evaluation of the severity and initiation of appropriate treatment are necessary. The Guidelines for the Management of Burn Injuries were issued in March 2009 from the Japanese Society for Burn Injuries as guidelines concerning burns, but they were focused on the treatment for extensive and severe burns in the acute period. Therefore, we prepared guidelines intended to support the appropriate diagnosis and initial treatment for patients with burns that are commonly encountered including minor as well as moderate and severe cases. Because of this intention of the present guidelines, there is no recommendation of individual surgical procedures.
Asunto(s)
Quemaduras/diagnóstico , Quemaduras/terapia , Fluidoterapia/métodos , Índice de Severidad de la Enfermedad , Cicatrización de Heridas , Administración Cutánea , Corticoesteroides/administración & dosificación , Corticoesteroides/uso terapéutico , Antibacterianos/uso terapéutico , Antiinfecciosos Locales/uso terapéutico , Vendajes , Broncoscopía , Quemaduras/clasificación , Quemaduras por Inhalación/diagnóstico , Quemaduras por Inhalación/terapia , Humanos , Hidroterapia , Pulmón/diagnóstico por imagen , Pomadas/administración & dosificación , Pomadas/uso terapéutico , Pronóstico , Radiografía , Sulfadiazina de Plata/uso terapéutico , Tétanos/prevención & control , Toxoide Tetánico/uso terapéutico , Infección de Heridas/prevención & controlRESUMEN
The Wound/Burn Guidelines Committee consists of members commissioned by the Board of Directors of the Japanese Dermatological Association (JDA). It held several meetings and evaluations in writing since October 2008, and drafted five guidelines for the diagnosis and treatment including commentaries on wounds in general and the Guidelines for the Diagnosis and Treatment for Pressure Ulcers by taking opinions of the Scientific Committee and Board of Directors of JDA into consideration.
Asunto(s)
Quemaduras/diagnóstico , Quemaduras/terapia , Úlcera por Presión/diagnóstico , Úlcera por Presión/terapia , Cicatrización de Heridas , Administración Cutánea , Vendajes , Desbridamiento , Dermatología/normas , Diagnóstico Diferencial , Práctica Clínica Basada en la Evidencia/normas , Humanos , Japón , Pomadas , Manejo del Dolor/métodos , Posicionamiento del Paciente , Úlcera por Presión/prevención & control , Úlcera por Presión/cirugía , Cuidados de la Piel/métodosRESUMEN
The Japanese Dermatological Association prepared guidelines focused on the treatment of skin ulcers associated with connective tissue disease/vasculitis practical in clinical settings of dermatological care. Skin ulcers associated with connective tissue diseases or vasculitis occur on the background of a wide variety of diseases including, typically, systemic sclerosis but also systemic lupus erythematosus (SLE), dermatomyositis, rheumatoid arthritis (RA), various vasculitides and antiphospholipid antibody syndrome (APS). Therefore, in preparing the present guidelines, we considered diagnostic/therapeutic approaches appropriate for each of these disorders to be necessary and developed algorithms and clinical questions for systemic sclerosis, SLE, dermatomyositis, RA, vasculitis and APS.
Asunto(s)
Calcinosis/complicaciones , Enfermedades del Tejido Conjuntivo/complicaciones , Úlcera Cutánea/tratamiento farmacológico , Vasculitis/complicaciones , Antitrombinas/uso terapéutico , Calcinosis/diagnóstico , Calcinosis/terapia , Bloqueadores de los Canales de Calcio/uso terapéutico , Dapsona/uso terapéutico , Antagonistas de los Receptores de Endotelina/uso terapéutico , Glucocorticoides/uso terapéutico , Humanos , Inmunosupresores/uso terapéutico , Leucaféresis , Inhibidores de Fosfodiesterasa 5/uso terapéutico , Inhibidores de Agregación Plaquetaria/uso terapéutico , Prostaglandinas/uso terapéutico , Úlcera Cutánea/etiología , Úlcera Cutánea/cirugía , Factor de Necrosis Tumoral alfa/antagonistas & inhibidoresRESUMEN
The Japanese Dermatological Association determined to prepare the Wound/Burn Guidelines focusing on treatments, catering to needs for the clinical practice of dermatology. Among these guidelines, "Wounds in General" was intended to explain knowledge necessary "to heal wounds" without specifying particular disorders.
Asunto(s)
Antiinfecciosos Locales/uso terapéutico , Quemaduras/terapia , Desinfección/métodos , Irrigación Terapéutica/métodos , Cicatrización de Heridas , Heridas y Lesiones/terapia , Administración Cutánea , Antiinfecciosos Locales/administración & dosificación , Enfermedad Crónica , Humanos , Japón , Sociedades Médicas , Irrigación Terapéutica/normas , Heridas y Lesiones/clasificación , Heridas y Lesiones/diagnósticoRESUMEN
We aimed to prepare guidelines for the management of diabetic ulcer/gangrene with emphasis on the diagnosis and treatment of skin symptoms. They serve as a tool to improve the quality of the diagnosis and treatment in each patient and, further, to improve the level of the care for diabetic ulcer in Japan by systematically presenting evidence-based recommendations for clinical judgments by incorporating various viewpoints.
Asunto(s)
Pie Diabético/terapia , Gangrena/terapia , Aldehído Reductasa/antagonistas & inhibidores , Antibacterianos/administración & dosificación , Eliminación de Componentes Sanguíneos , Desbridamiento , Pie Diabético/complicaciones , Pie Diabético/diagnóstico , Nefropatías Diabéticas/diagnóstico , Gangrena/diagnóstico , Gangrena/etiología , Humanos , Oxigenoterapia Hiperbárica , Isquemia/diagnóstico , Isquemia/etiología , Terapia de Presión Negativa para Heridas , Aparatos Ortopédicos , Osteomielitis/diagnóstico por imagen , Osteomielitis/tratamiento farmacológico , Osteomielitis/etiología , Diálisis Renal/efectos adversos , Cicatrización de HeridasRESUMEN
Varicose veins are treated at multiple clinical departments, but as patients often visit the dermatology clinic first due to leg ulcers, the present Guidelines for the Management of Lower Leg Ulcers/Varicose Veins were prepared in consideration of the importance of the dermatologist's role. Also, the disease concept of chronic venous insufficiency or chronic venous disorders and the CEAP classification of these disorders are presented. The objective of the present guidelines is to properly guide the diagnosis and treatment of lower leg ulcers/varicose veins by systematically presenting evidence-based recommendations that support clinical decisions.