Research on the perioperative care pathway of photodynamic therapy for port-wine stain patients in enhanced recovery after surgery

doi:10.19438/j.cjoms.2026.04.011

Abstract

Abstract: PURPOSE: Based on the journey map, to identify the multi-dimensional needs of patients with port-wine stain (PWS) undergoing photodynamic therapy (PDT) under general anesthesia, and to provide a reference for optimizing the perioperative diagnosis and treatment experience of this group and forming a patient-centered medical support system. METHODS: A descriptive qualitative research method was used. From September to November 2025, 12 patients with port-wine stain at Hemangioma Department of Henan Provincial People's Hospital were selected for semi-structured interviews. The data were analyzed by content analysis method, and the patient journey map was drawn. RESULTS: Taking the three periods of pre-operation, operation and post-operation of patients with port-wine stain as the time axis, the perioperative journey of patients with port-wine stain undergoing photodynamic therapy was divided into 34 themes from four dimensions of task, emotion, pain point and opportunity point, including outpatient visit, surgical plan confirmation, preoperative preparation, access to high-quality medical resources, psychological support, confusion, anxiety, tension, etc., and the journey map was drawn. CONCLUSIONS: Under the Enhanced Recovery After Surgery (ERAS) model, patients with port-wine stain (PWS) undergoing photodynamic therapy under general anesthesia (PDT) exhibit characteristics of a short treatment cycle and complex healthcare management needs during the perioperative period. The dynamic and intertwined clinical experience touchpoints evolve across different stages, with varying priorities in health support needs. Optimizing core interactive touchpoints enables precise response to diverse patient needs, enhances overall clinical experience and patient's satisfaction, and ensures high-quality nursing services throughout the entire perioperative process. This approach aligns with the ERAS philosophy of minimizing physiological and psychological stress while promoting accelerated recovery.

Key words: Patient journey map, Port-wine stain, Diagnosis and treatment experience, Enhanced recovery after surgery, Nursing

CLC Number:

R739.8

Hu Guangzhen, Wang Xiaolu, Huang Jing, Dong Changxian, Lei Hongzhao, Li Xinlu, Wang Cuitian, Hu Hengyu. Research on the perioperative care pathway of photodynamic therapy for port-wine stain patients in enhanced recovery after surgery[J]. China Journal of Oral and Maxillofacial Surgery, 2026, 24(4): 389-395.

References

[1] 钱玥, 马正良. 快速康复外科理念下日间手术的麻醉与围术期质量控制[J]. 实用医学杂志, 2024, 40(8): 1042-1046.
Qian Y, Ma ZL.Anesthesia and perioperative quality control of ambulatory surgery under the concept of rapid recovery surgery[J]. The Journal of Practical Medicine, 2024, 40(8): 1042-1046.
[2] Alper JC, Holmes LB.The incidence and significance of birthmarks in a cohort of 4 641 newborns[J]. Pediatr Dermatol, 1983, 1(1): 58-68.
[3] 郭利劭, 张建中. 儿童鲜红斑痣的激光治疗进展[J]. 中华皮肤科杂志, 2010, 43(5): 369-371.
Guo LS, Zhang JZ.Progress in laser treatment of infantile port-wine stains[J]. Chinese Journal of Dermatology, 2010, 43(5): 369-371.
[4] 黄渊柏, 杨军, 毕鸣晔, 等. Sturge-Weber综合征患者面部鲜红斑痣的光动力治疗疗效观察[J]. 临床皮肤科杂志, 2024, 53(2): 69-74.
Huang YB, Yang J, Bi MY, et al.Efficacy of photodynamic therapy for facial port-wine stains in patients with Sturge-Weber syndrome[J]. Journal of Clinical Dermatology, 2024, 53(2): 69-74.
[5] Smets G, Gutermuth J, Grosber M, et al.Pulsed dye laser for facial erythema in Netherton syndrome[J]. J Eur Acad Dermatol Venereol, 2024, 38(3): e229-e230.
[6] Han Y, Ying H, Zhang X, et al.Retrospective study of photodynamic therapy for pulsed dye laser-resistant port-wine stains[J]. J Dermatol, 2020, 47(4): 348-355.
[7] Liu L, Li X, Zhao Q, et al.Pathogenesis of port-wine stains: directions for future therapies[J]. Int J Mol Sci, 2022, 23(20): 12139.
[8] Min Z, Jing L, Jun Z, et al.Influential factors in the efficacy of hemoporfin-mediated photodynamic therapy for port-wine stains[J]. Lasers Med Sci, 2023, 38(1): 162.
[9] 周循, 索璐璐, 刘锦星, 等. 颌面部鲜红斑痣患儿光动力治疗苏醒期躁动的影响因素及药物干预措施的观察性研究[J]. 中国口腔颌面外科杂志, 2024, 22(3): 261-267.
Zhou X, Suo LL, Liu JX, et al.Influencing factors and drug intervention measures for emergence agitation during photodynamic therapy in children with nevus flammeus in the maxillofacial region:an observational study[J]. China Journal of Oral and Maxillofacial Surgery, 2024, 22(3): 261-267.
[10] 杜悦, 刘华绪. 获得性鲜红斑痣研究进展[J]. 临床皮肤科杂志, 2025, 54(9): 564-566.
Du Y, Liu HX.Research progress on acquired port-wine stains[J]. Journal of Clinical Dermatology, 2025, 54(9): 564-566.
[11] 李东, 李晓阳, 张鹏飞, 等. 基于反射光谱测量和辐射反方法的鲜红斑痣激光热疗临床疗效量化评估[J]. 中国激光, 2025, 52(9): 166-175.
Li D, Li XY, Zhang PF, et al.Quantitative evaluation of clinical efficacy of laser thermotherapy for port-wine stains through reflectance spectra measurements and an inverse radiation algorithm[J]. Chinese Journal of Lasers, 2025, 52(9): 166-175.
[12] Tian R, Wang Q, Li S, et al.Non-invasive efficacy assessment of pulsed dye laser and photodynamic therapy for port-wine stain[J]. Indian J Dermatol Venereol Leprol, 2024, 90(5): 615-622.
[13] Li X, Diao P, Liu L, et al.Hematoporphyrin monomethyl ether photodynamic therapy for the treatment of Sturge-Weber syndrome and large segmental facial port-wine stain[J]. Dermatol Ther, 2022, 35(5): e15404.
[14] Yu Y, Tang S, Luo Y, et al.Efficacy and influential factors of hematoporphyrin monomethyl ether mediated photodynamic therapy in the treatment for port-wine stains[J]. Photodiagnosis Photodyn Ther, 2024, 45: 103933.
[15] 中华医学会整形外科分会血管瘤脉管畸形学组. 血管瘤与脉管畸形诊疗指南(2024版)[J]. 组织工程与重建外科, 2024, 20(1): 1-50.
Chinese society for the study of vascular anomalies (CSSVA). CSSIV guidelines for vascular anomalies 2024[J]. Journal of Tissue Engineering and Reconstructive Surgery, 2024, 20(1): 1-50.
[16] 王文韬, 侯京豫, 钱鹏博, 等. 用户体验地图:图书馆用户体验馆员的新工具[J]. 图书情报知识, 2023, 40(5): 107-117.
Wang WT, Hou JY, Qian PB, et al.User experience map: a new tool for library user experience librarians[J]. Documentation,Information & Knowledge, 2023, 40(5): 107-117.
[17] Davies EL, Bulto LN, Walsh A, et al.Reporting and conducting patient journey mapping research in healthcare: a scoping review[J]. J Adv Nurs, 2023, 79(1): 83-100.
[18] Harris R, Murray D, McSweeney A, et al. Clinician-focused connected health requirements gathering for attention-deficit/hyperactivity disorder through clinical journey mapping: design science study[J]. JMIR Form Res, 2025, 9: e53617.
[19] Bulto LN, Davies E, Kelly J, et al.Patient journey mapping: emerging methods for understanding and improving patient experiences of health systems and services[J]. Eur J Cardiovasc Nurs, 2024, 23(4): 429-433.
[20] Fang S, Chen F, Zhu X, et al.Journey mapping for symptom management in adolescents with depression: a longitudinal qualitative study of dynamic patient-centered pathways[J]. J Multidiscip Healthc, 2025,18: 5039-5060.
[21] 朱瑾, 张容, 洪妙璇, 等. 基于认知行为疗法的心理干预在Stanford A型主动脉夹层病人中的应用[J]. 护理研究, 2024, 38(13): 2390-2395.
Zhu J, Zhang R, Hong MX, et al.Application of psychological intervention based on cognitive behavioral therapy theory in Stanford type A aortic dissection patients[J]. Chinese Nursing Research, 2024, 38(13): 2390-2395.
[22] 李莉, 刘永玲, 张洋, 等. 虚拟现实康复支持系统对喉切除术后患者照顾者出院准备度的影响研究[J]. 中华护理杂志, 2025, 60(20): 2451-2457.
Li L, Liu YL, Zhang Y, et al.Effects of a virtual reality rehabilitation support system on discharge readiness among caregivers of post-laryngectomy patients[J]. Chinese Journal of Nursing, 2025,60(20): 2451-2457.
[23] Li D, Chen B, Zhang H, et al.Retrospective study of the treatment of port-wine stains with 595-nm pulsed dye laser in 261 Chinese patients[J]. Lasers Med Sci, 2020, 35(8): 1811-1819.