Closure Rate of Chronic Wound With Sinus Tract Based on Morphological and Pathological Features of the Endoscopic Evaluated Classification
Summary: This prospective case series at Ruijin Hospital (2017-2021) evaluated the endoscopic evaluated classification (China-Lu system) for chronic wounds with sinus tracts (CWST), categorizing 89 patients into simple, morphologically complex, pathologically complex, or refractory types based on tract branches and features like fibrosis/necrosis. Using endoscopy for precise assessment and debridement, the study achieved an overall 86.52% closure rate post-treatment, with simple wounds excelling at 97.83% and refractory types lagging at 14.29%. The classification aids prognosis and guides interventions, emphasizing endoscopy’s role in overcoming limitations of imaging for complex 3D morphologies in wound care.
Key Highlights:
- Patient cohort: 89 adults (mean age 53 years, 51.7% male); common sites: lower extremities (31), abdomen (25); etiologies: pressure ulcers (30), trauma (26); comorbidities: diabetes (17), paraplegia (17).
- Classification: Simple (46 patients, single tract, no features: 97.83% closure); morphologically complex (13, multiple tracts: 84.62%); pathologically complex (23, single tract with features: 86.96%); refractory (7, multiple tracts with features: 14.29%).
- Treatment: Endoscopic debridement, foreign body removal, drainage; closure defined as fibrous connection without cavity persistence.
- Outcomes: Overall 86.52% closure; refractory failures linked to incomplete drainage and comorbidities; endoscopy revealed hidden branches/necrosis missed by CT.
- Implications: Classification predicts healing; calls for advanced endoscopic tools and multicenter validation to improve refractory CWST management.
Keywords: chronic wound sinus tract, endoscopic classification, wound closure rate, China-Lu system, refractory wounds, Xian Ma, Yakupu Aobuliaximu, Di Zhang