Regenerative medicine has rapidly developed over the past decade and created new opportunities to repair or replace tissue or organ function lost because of congenital defects, age, diseases, or serious damage （Cheng et al., 2016a; Cheng et al., 2016b）. Regenerative medicine strategies in- clude the transplantation of bioactive factors, stem cells, or biomaterials, even the induced regeneration in a de novo, depending on the application （Fu, 2014a; Huang and Fu, 2014）. However, there are several limitations to the use of regenerative medicine in the clinic with respect to using stem cells and biomaterials.
Iatrogenic wounds are a common but often overlooked concept.They can lead to increases in hospital stays,therapy costs,repeat surgeries,and implant removal.If not handled properly,these wounds have a very poor prognosis and will cause serious physical and psychological harm to patients,which may result in medicolegal disputes.In recent years,the incidence of iatrogenic wounds has increased because of(1)an increase in the population of older people owing to increased life expectancy,(2)the continued expansion of surgical indications,(3)an increase in difficult surgeries,and(4)the constant emergence and application of new implantable biomaterials and other therapies.Thus,there is a pressing clinical need to improve the therapy of iatrogenic wounds.However,the difficulty in treating these wounds is considerable due to the emergence of drug-resistant bacteria,the high number of patients with metabolic diseases,and complex complications in patients.In particular,iatrogenic wounds caused by surgical site infections due to implantable biomaterials could lead to material leakage and conflicts regarding whether to retain or remove the implants.This review provides a definition of iatrogenic wounds,describes their characteristics,classifies them,and provides information about the importance of analyzing iatrogenic wounds.We hope that this review will provide useful information for the diagnosis and treatment of iatrogenic wounds and help to reduce their incidence in the future.
目的：回顾性调查难愈合创面住院患者的形成原因、好发部位以及住院时间等情况，为难愈合创面的防治以及研究提供资料。方法：收集2011年7月至2013年12月期间广州军区广州总医院整形外科因创面问题住院患者的病历资料。以皮肤组织缺损经2个月治疗未愈合为判定标准，筛选出难愈合创面患者120例，回顾性调查患者创面形成原因、年龄、创面发生部位、住院时间等情况。结果：我科共收治住院患者2136例，其中难愈性创面患者120例，占5．6％。创面形成的主要原因为代谢性疾病（43．3％），其次为创伤感染类（20％）和肿瘤类（20．0％）（χ2＝62．917， P ＜0．01）。创面难愈患者高发年龄段为40～60岁，其次为60～80岁（χ2＝29．562， P ＜0．01）。难愈合创面好发部位为四肢（61．6％），又以足部最为多见（占38．3％）（χ2＝17．546， P＝0．002）。目前我科全部住院患者平均住院时间为（7．41±8．98） d，慢性创面住院患者平均住院时间[（33．21±28．27） d]较同期所有住院患者明显延长（t＝－9．968， P＜0．05）。结论：代谢类疾病的中老年患者成为难愈性创面主要人群，难愈创面常发生在四肢，严重影响患者的行动，造成住院时间拖延，给患者家属、社会均带来极大负担。
