ABSTRACT
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.
Subject(s)
Pressure Ulcer , Bandages , Humans , Pressure Ulcer/therapy , Wound HealingABSTRACT
"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.
Subject(s)
Pressure Ulcer , Bandages , Humans , Pressure Ulcer/diagnosis , Pressure Ulcer/therapyABSTRACT
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.
Subject(s)
Connective Tissue Diseases , Lupus Erythematosus, Systemic , Pressure Ulcer , Skin Diseases, Vascular , Skin Ulcer , Vasculitis , Humans , Skin Ulcer/diagnosis , Skin Ulcer/drug therapy , Skin Ulcer/etiology , Vasculitis/diagnosis , Vasculitis/drug therapySubject(s)
Pressure Ulcer , Bandages , Humans , Pressure Ulcer/diagnosis , Pressure Ulcer/therapy , Wound HealingABSTRACT
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.
Subject(s)
Burns/diagnosis , Burns/therapy , Fluid Therapy/methods , Severity of Illness Index , Wound Healing , Administration, Cutaneous , Adrenal Cortex Hormones/administration & dosage , Adrenal Cortex Hormones/therapeutic use , Anti-Bacterial Agents/therapeutic use , Anti-Infective Agents, Local/therapeutic use , Bandages , Bronchoscopy , Burns/classification , Burns, Inhalation/diagnosis , Burns, Inhalation/therapy , Humans , Hydrotherapy , Lung/diagnostic imaging , Ointments/administration & dosage , Ointments/therapeutic use , Prognosis , Radiography , Silver Sulfadiazine/therapeutic use , Tetanus/prevention & control , Tetanus Toxoid/therapeutic use , Wound Infection/prevention & controlABSTRACT
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.
Subject(s)
Burns/diagnosis , Burns/therapy , Pressure Ulcer/diagnosis , Pressure Ulcer/therapy , Wound Healing , Administration, Cutaneous , Bandages , Debridement , Dermatology/standards , Diagnosis, Differential , Evidence-Based Practice/standards , Humans , Japan , Ointments , Pain Management/methods , Patient Positioning , Pressure Ulcer/prevention & control , Pressure Ulcer/surgery , Skin Care/methodsABSTRACT
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.
Subject(s)
Calcinosis/complications , Connective Tissue Diseases/complications , Skin Ulcer/drug therapy , Vasculitis/complications , Antithrombins/therapeutic use , Calcinosis/diagnosis , Calcinosis/therapy , Calcium Channel Blockers/therapeutic use , Dapsone/therapeutic use , Endothelin Receptor Antagonists/therapeutic use , Glucocorticoids/therapeutic use , Humans , Immunosuppressive Agents/therapeutic use , Leukapheresis , Phosphodiesterase 5 Inhibitors/therapeutic use , Platelet Aggregation Inhibitors/therapeutic use , Prostaglandins/therapeutic use , Skin Ulcer/etiology , Skin Ulcer/surgery , Tumor Necrosis Factor-alpha/antagonists & inhibitorsABSTRACT
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.
Subject(s)
Anti-Infective Agents, Local/therapeutic use , Burns/therapy , Disinfection/methods , Therapeutic Irrigation/methods , Wound Healing , Wounds and Injuries/therapy , Administration, Cutaneous , Anti-Infective Agents, Local/administration & dosage , Chronic Disease , Humans , Japan , Societies, Medical , Therapeutic Irrigation/standards , Wounds and Injuries/classification , Wounds and Injuries/diagnosisABSTRACT
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.
Subject(s)
Diabetic Foot/therapy , Gangrene/therapy , Aldehyde Reductase/antagonists & inhibitors , Anti-Bacterial Agents/administration & dosage , Blood Component Removal , Debridement , Diabetic Foot/complications , Diabetic Foot/diagnosis , Diabetic Nephropathies/diagnosis , Gangrene/diagnosis , Gangrene/etiology , Humans , Hyperbaric Oxygenation , Ischemia/diagnosis , Ischemia/etiology , Negative-Pressure Wound Therapy , Orthotic Devices , Osteomyelitis/diagnostic imaging , Osteomyelitis/drug therapy , Osteomyelitis/etiology , Renal Dialysis/adverse effects , Wound HealingABSTRACT
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.
