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日本高気圧環境・潜水医学会雑誌 Vol.46（4）,Dec,2011

シンポジウムS2-5Hyperbaric oxygen therapy plays a key role in the development of wound care center in Taiwan

TsaiWen-PingDivisionofPlasticSurgery,DepartmentSurgery,

DepartmentofHyperbaricOxygenandWoundCareCenter,Shuang-HoHospital,TaipeiMedicalUniversity,

Taipei,Taiwan.

Woundcareisnowrecognizedasaninterdisciplinaryapproachtoproblemorchronicwounds.Integrationof different experts intowound care, includinginfection physician, endocrinologist, vascularsurgeon,plasticsurgeon,nutritionist,woundcarenursespecialist,etc.,isoneimportantpointtothesuccessofwoundcenterdevelopment.Hyperbaricoxygen (HBO) treatment, a proved powerfuladjuvanttherapyinwoundhealing,playsakeyroleintheestablishmentofwoundcarecenter.DuringthetreatmentcourseofHBO,patientscanreceiveregularfollowupforwoundevaluationaswellaswounddressingchange.Treatmentstrategiescanalsobeadjustedormodifiedaccordinglywithoutdelay. Interdisciplinaryconsultationandmeetingcanalsobeheldfrequently.

InTaiwan, there are about35multi-chamberHBO centers.About one fourth of the centersfocusedonproblemwoundandthenumberisstillincreasing.Ourwound care center, hyperbaricoxygen treatment and wound care center inShuang-HoHospital, isanewlyestablishedHBOcenter focused onwound care inTaiwan.Thecharacteristicsofourcenteraremultidisciplinarywound care team, individualized wound caretreatmentplanandsmartphone-basedtelemedicine.Ourwound care team includes plastic surgeon,vascular surgeon, cardiovascular physician,endocrinologist, infection physician andwoundcare nursing staff, etc.Weekly case discussionandbi-weekly interdisciplinarymeetingareheldconsistently. Every patient visited our centerwill be suggested an individualized treatmentplan for wound healing recorded in a“woundcare passport”.The patient can involvemoreinto their treatmentprogressbycheckingone’sown“passport”athand.The“smart-phonebasedtelemedicine”,withthehelpofworldwideincreasingpopularity of smartphone, is a newly developed

systemforreal-time interactionbetweenpatientsandmedicalstaffs.Patientcansend thepicturesofwound taken from their smartphone to ourwoundcaredatabase.Andourmedicalstaffwilladviseadequatemanagement topatientor familyimmediatelyonline(Fig1).Itwillnotonlyimprovethe compliance of patients and also savemoretime and labor especially for disabled patients.Besides,wealsoestablishedablogand forumofourwoundcarecenterforeducationanddiscussionwithpatient and their family (Fig2).All thosecharacteristicsarederivedfrom“patient-oriented”concept.OnHBO treatment course, patient canreceive other ancillary treatments or dressingchangeatthesametimeinourcenter.AfterHBOtreatmentcourse,patient can finish theirwoundcare treatment in our center or receive onlinefollow-upsby“smart-phonebased telemedicine”tillthewoundheals.

Though theHBOtreatments to improvewoundhealing isnotcoveredbypublichealth insuranceinTaiwan, thenumberofpatients came for thisindication is increasing greatly.Webelieve andhope that ourmodel of hyperbaric oxygen andwoundcarecenter ishelpful to facilitatewoundhealingandalsoimprovepatientcare.

Fig 1. Smart-phone based telemedicine to facilitate wound care.

Fig 2. “Wound-care blog” for education and discussion with patient and their family. (http://i-woundcare.com/blog)