慢性伤口处理.ppt

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1、woundcleaning--Techniques伤口清洁---技术Componentswhichneedtoberemovedfromwoundbed需要从创面去除的部分Surplusexudate多余渗出物Necrotictissue坏死组织Deadcells死亡细胞Breadinggroundforbacteriaandcomponentswhichmightbesupportivetothedevelopmentofbiofilms.细菌滋养环境以及可能会促进生物被膜形成的成分woundcleaning伤口清洁

2、Generalgoal总体目标Toremovedebriesandfroeignbodies.去除碎屑与异物Necrotictissue坏死组织Deadcells死亡细胞Fibrin纤维蛋白Toxins，MMP毒素，MMPForeignbodies(forinstanceremainsforpreviouslyuseddressings)异物（例如先前使用的敷料）Woundcleaning--Techniques伤口清洁-----技术Requirementsonwoundrinsingsolutions对伤口冲洗液的

3、要求Shouldbesterilie无菌Notcolored无色Genteltocells/nontoxic细胞温和型/无毒Bodytemperature(coolingdownwoundbedreducesorinactivatescellactivity)>28℃nofunction体温（冷却创面、减少细胞活性或使其灭活）>28℃无效Woundcleaning伤口清洁Ways方法Basiccleanningofwoundbed,woundedgesandsurroundingarea对伤口创面、边缘以及周围进行基本

4、清洗Antibacteiracleanning抗菌剂清洗Woundrinsing伤口冲洗WoundcleaningWettodry干燥清洗伤口Debridement清创术Negtivepressure负压Woundcleaning伤口清洁----技术CleanigwithRinsingsolution采用冲洗溶液进行清洗Saline生理盐水Ringersolution林格氏液Indication:Cleaningwound适应症：清洁伤口Nontouchtechnique非接触技术Woundcleaning伤口清洁

5、----技术Cleanningwithantisepticsolution采用消毒溶液进行清洗Octenidin-di-hydrochlorid奥替尼啶盐酸化合物Polyhexanid聚已缩胍Iodine碘Indication:Infectedandcontaminatedwound适应症：感染伤口和污染伤口Nontouchtechnique:Fromoutsidetocenterofwoundinordertoavoidfurtherspreadingofbacteriatothesurroundingarea.非接

6、触技术：从外围向中间清洗以避免细菌向周围进一步播散Woundcleaning--Antisepticsolution伤口清洁--消毒溶液Octenidin-di-hydrochlorid奥替尼啶盐酸化合物Polyhexanid聚已缩胍Advantages优点notcolored,notinacticatedbybodyfluids无色、不会被体液灭活donotinitiateresistance,skinirritationandallergies不会引起抗药性、皮肤刺激或过敏Disadvantages缺点notava

7、ilableandreimbursedinmanycountries在许多地区不能使用而且不能报销不能采用高压将奥替尼啶注入腔内加以应用Bothshouldnotbeappliedoncartilageandincontactwithinternalorgans(abdominalcavity)二者均不能在软骨上运用，且不能与内部器官接触（腹腔）Woundcleaning--Antisepticsolution伤口清洁--消毒溶液IodineAdvantages优点EffevtiveagainstGrampostive

8、andGramnegtivebacteria可有效对抗革兰阳氏和阴性菌Availableindifferentformsforapplication(ointment,lotions)可以采用不同形式加以运用（软膏、洗液）Disadvantages缺点Colored(makeswoundassessmentdifficult)有色