形成外科医が行う在宅医療

Wound Treatment by Plastic Surgeons in Home Care Settings

はじめに

　在宅医療は，患者が自宅で生活をしながら家族とともに治療を行うという，医師：患者：家族の信頼関係と地域を基盤にした全人的医療を追求すべきものである。当然，病院で行うことができる最先端の医療とは異なるが，現在の病院での医療では得られない利点が多くある。在宅医療というと内科慢性疾患が一般的であったが，近年，形成外科医による創傷治療が注目されている。

　本稿では，形成外科医による在宅における創傷治療の可能性と限界，将来の展望について概説する。

　Home medical care is designed to provide holistic medical care based on community-based relationships of trust among physicians and other medical care providers, their patients, and patients' families, in which patients receive treatment at home in the presence of their families. Medical care performed at home is generally for chronic internal diseases, and from the perspective of long-term hospitalization, the barriers to treating chronic wounds in acute-care hospitals are high. Wound treatment performed in home settings by plastic surgeons has recently gained attention, as there are three advantages to performing wound care at home:

　-High-quality medical care by a plastic surgeon that is equivalent to hospitalized care can be provided while the patient remains at home.

　-The plastic surgeon can follow chronic wounds from the time point of the wound's development until complete healing

　-Wound care at home by a plastic surgeon helps shorten the length of stay in acute-care hospitals.

　Considering chronic wounds' long-term healing process, wound care at home will become increasingly important in the future.