齊魯醫(yī)學(xué)慢性傷口處理

woundcleaning--Techniques傷口清潔---技術(shù)Componentswhichneedtoberemovedfromwoundbed需要從創(chuàng)面去除的部分Surplusexudate多余滲出物Necrotictissue壞死組織Deadcells死亡細(xì)胞Breadinggroundforbacteriaandponentswhichmightbesupportivetothedevelopmentofbiofilms.細(xì)菌滋養(yǎng)環(huán)境以及可能會促進(jìn)生物被膜形成的成分慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第1頁!woundcleaning傷口清潔Generalgoal總體目標(biāo)Toremovedebriesandfroeignbodies.去除碎屑與異物Necrotictissue壞死組織Deadcells死亡細(xì)胞Fibrin纖維蛋白Toxins，MMP毒素，MMPForeignbodies(forinstanceremainsforpreviouslyuseddressings)異物（例如先前使用的敷料）慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第2頁!Woundcleaning--Techniques

傷口清潔-----技術(shù)Requirementsonwoundrinsingsolutions對傷口沖洗液的要求Shouldbesterilie無菌Notcolored無色Genteltocells/nontoxic細(xì)胞溫和型/無毒Bodytemperature(coolingdownwoundbedreducesorinactivatescellactivity)>28℃nofunction體溫（冷卻創(chuàng)面、減少細(xì)胞活性或使其滅活）>28℃無效慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第3頁!Woundcleaning傷口清潔

----技術(shù)CleanigwithRinsingsolution采用沖洗溶液進(jìn)行清洗Saline生理鹽水Ringersolution林格氏液Indication:Cleaningwound適應(yīng)癥：清潔傷口Nontouchtechnique非接觸技術(shù)慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第4頁!Woundcleaning--Antisepticsolution

傷口清潔--消毒溶液Octenidin-di-hydrochlorid奧替尼啶鹽酸化合物Polyhexanid聚已縮胍Advantages優(yōu)點notcolored,notinacticatedbybodyfluids無色、不會被體液滅活donotinitiateresistance,skinirritationandallergies不會引起抗藥性、皮膚刺激或過敏Disadvantages缺點notavailableandreimbursedinmanycountries在許多地區(qū)不能使用而且不能報銷不能采用高壓將奧替尼啶注入腔內(nèi)加以應(yīng)用Bothshouldnotbeappliedoncartilageandincontactwithinternalorgans(abdominalcavity)二者均不能在軟骨上運(yùn)用，且不能與內(nèi)部器官接觸（腹腔）慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第5頁!Wounddebridement清創(chuàng)術(shù)Incaseofachronic,difficulttohealwoundcleaningcanbesupportedwithdifferentwaysofdebridement在慢性、難愈合性傷口的清潔中可才采用不同的清創(chuàng)術(shù)進(jìn)行支持治療Requirements要求：Asgentleaspossible盡可能溫柔Asthoroughaspossible盡可能徹底Assoonaspossible盡早慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第6頁!Debridementmethods傷口清創(chuàng)方法機(jī)械清創(chuàng)（傷口清洗和傷口浴，水下低頻超聲波處理、聚氨酸脂類軟性泡沫復(fù)合物產(chǎn)品等）Mechanicaldebridement外科清創(chuàng)（剪刀、手術(shù)刀、鋒利勺、刮器）Surgicaldebridement酶清創(chuàng)（蛋白質(zhì)、肽類）Enzymaticdebridement生物清創(chuàng)Biosurgicaldebridement自溶性清創(chuàng)（內(nèi)活性傷口敷料、如水膠體、水凝膠）Autolyticdebridement慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第7頁!Wounddebridemen清創(chuàng)術(shù)Surgical手術(shù)清創(chuàng)Removalofdebriswithcurette,abrasororscapel采用刮匙、刮除器或手術(shù)刀去除碎屑Usuallyperformedbysurgeonorspeciallytrainednursesundersupervisionofsurgeon.通常由外科醫(yī)生執(zhí)行清創(chuàng)或者在外科醫(yī)生的監(jiān)督下由護(hù)士進(jìn)行清創(chuàng)。Cave空洞Mightbepainfulforpatient可能會引起患者疼痛Chanceofbleeding可能會出血InseverecasesintmustbeconductedinOR嚴(yán)重時必須采用手術(shù)進(jìn)行處理慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第8頁!Wounddebridemen清創(chuàng)術(shù)Biosurgicalwithmaggots采用蛆進(jìn)行生物手術(shù)Serratiamarcecens沙雷桿菌Advantage優(yōu)點Veryselectivecleaning/Antisepticeffect選擇性清潔/防腐作用Stimulategranulation刺激肉芽生長Almostpainfree幾乎無痛Disadvantage缺點Notalwayseasytoapplyandkeepinplace不容易使用而且不容易固定。Ethicalaspectsneedconsideration.需要對倫理學(xué)方面加以考慮。慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第9頁!TheevolutionandapplicationofdressingsGauze

OilYam、stickingHydrocolloiddressingsAntibacterialdressings干紗布油砂、敷貼水膠體抗菌敷料、生物活性敷料慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第10頁!Wounddressings-Requirements

傷口敷料—要求Keyfunctions主要作用Keepwoundbedmoist保持創(chuàng)面濕潤Keepwoundsurroundingskindry保持傷口周圍皮膚干燥Avoidcoolingdownofwoundtemperature避免傷口溫度降低Protectfrominfection預(yù)防感染Shouldnotleaveresidualsinwound傷口內(nèi)不應(yīng)留下殘余物慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第11頁!Wounddressings-DifferentkindsCriteriaforselection選擇標(biāo)準(zhǔn)Woundsite傷口位置Exudate滲出物Signsofinfection感染跡象Conditionofwoundsurroundingskin傷口周圍皮膚狀況Pain疼痛慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第12頁!Wounddressings-Wettherapy(TenderWet)

傷口敷料—濕潤療法（德濕威TenderWet）Description說明Hydroactivedressingpadforwettherapy采用水活化性敷料墊用于濕潤療法Madeofhighlyabsorbingpolyacrylate采用高吸水性聚丙烯酸酯制造Activeabsorbingandrinsingeffect具有有效吸收和沖洗作用AlreadyactivatedversionplusseparateRingersolutionavailable可以采用已活化型或者未活化型外加林格氏液。慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第13頁!Wounddressings-Wettherapy(TenderWet)

傷口敷料—濕潤療法（德濕威TenderWet）Predominateuseinfollowingphasesofwoundhealing主要應(yīng)用于傷口愈合的以下階段Cleaning清潔Cleaning+Granulation清洗+肉芽形成Granulation肉芽形成Rehydratesescharsupportautolyticmechanisms再次水化焦痂有助于自溶機(jī)制ReduceMMP減少M(fèi)MPProtectsandmaintainsclean保持并維持清潔慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第14頁!Wounddressings-Wettherapy(TenderWet)

傷口敷料—濕潤療法（德濕威TenderWet）Contraindication禁忌癥Escharduetountreatedarterialulceration由未經(jīng)治療的動脈性潰瘍所導(dǎo)致的焦痂Exercisecaution注意Contactofdressingwithwoundbedmustbesecured敷料和創(chuàng)面必須牢固接觸慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第15頁!Wounddressings-Wettherapy(TenderWet)

傷口敷料—濕潤療法（德濕威TenderWet）Fixation固定Fixationwithnonabsorbentdressing,bandageornonwovenadhesive以非吸收性敷料、繃帶或非編織型膠帶進(jìn)行固定。慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第16頁!Wounddressings—Alginates

傷口敷料—藻酸鹽類敷料Keyobjectivesforapplication使用的主要目的Woundfilling填充傷口Supportofautolyticdebridementduetogetinformation凝膠形成有助于自溶性清創(chuàng)Absorptionofwoundexudate吸收傷口滲出液Embedbacteriaandtoxininstructure將細(xì)菌和毒物包裹在凝膠中Haemostaticeffect具有止血作用慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第17頁!Wounddressings—Alginates

傷口敷料—藻酸鹽類敷料Mainindication主要適應(yīng)癥Infectedwounds(deepandsuperficial)感染傷口（深部和表淺）Necroticwounds(deepandsuperficial)壞死傷口（深部和表淺）Woundswithstagnatinghealing愈合停止的傷口Woundswiithtendencyforbleeding存在出血傾向的傷口慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第18頁!Wounddressings—Alginates

傷口敷料—藻酸鹽類敷料Fixation固定Alginatesneedtobecoveredbyasecondarydressing藻酸鹽類敷料需要采用次級敷料加以覆蓋Non-infectedwoundFineporedfoamdressing:hydrocolloidorfilmdressing非感染性傷口：細(xì)孔泡沫敷料、水膠敷料或薄膜敷料InfectedwoundElasticgauzebandages:tubularbandagesornonwovenfixationproducts感染性傷口：彈力繃帶、筒形繃帶或非編織性固定產(chǎn)品慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第19頁!Wounddressings—Hydrofiberdressings

傷口敷料—親水性材料Keyobjectives使用主要目的Absorptionofwoundexudate吸收傷口滲出液Inclusionofwoundexudateevenunderpressure(pressiontherapy)即使可以在壓力作用下（加壓治療）也可以吸入傷口滲液Predominateuseinfollowingphasesofwoundhealing主要應(yīng)用于傷口愈合的以下階段Cleansing:Exudingsloughedwounds清潔：排除傷口腐肉Granulation:肉芽形成：很少慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第20頁!Wounddressings—Hydrofiberdressings

傷口敷料—親水性材料Contraindication禁忌癥Drywounds干燥傷口Drynecrosiswounds干性壞死Third-orforth-degreeburns3度或4度燒傷Exercisecaution注意None慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第21頁!Wounddressings—Hydrofiberdressings

傷口敷料—親水性材料Fixation固定Hydrofiberdressingsneedtobecoveredbyassecondarydressing富含纖維敷料需要采用次級敷料加以覆蓋Absorbingpads、gauzebandagesornonwovenfixationproducts吸收墊、紗布繃帶或非編織性產(chǎn)品慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第22頁!Wounddressings—Polyurethane/Foamdressings

傷口敷料—聚氨酯/泡沫敷料Predominateuseinfollowingphasesofwoundhealing主要應(yīng)用于傷口愈合的以下階段Cleaning清潔evenincaseofsloughy/necroticwounds，sometimesoninfectedwounds(withooutadhesiveborder)甚至可以用于壞死性傷口,有時可以用于感染性傷口（無粘性邊緣）Granulation肉芽形成Epithellialisation上皮形成thinfoamdressingonly只采用薄層泡沫敷料慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第23頁!Wounddressings—Polyurethane/Foamdressings

傷口敷料—聚氨酯/泡沫敷料Contraindication禁忌癥Infectedwounds(borderedversions)感染傷口（邊界模糊）Drywound干燥傷口Third-orforth-degreeandhigher3度或3度以上燒傷Necroticwounds.OnlyasacoverinbinationwithforinstanceHydrogelwound壞死傷口，只能與其他敷料合用坐覆蓋，如水凝膠敷料。Exercisecaution注意Possibilityofmacerationwhendressingcapacityisexhausted當(dāng)敷料吸收能力達(dá)極限時具有浸漬的可能慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第24頁!Wounddressings—Polyurethane/Foamdressings

傷口敷料—聚氨酯/泡沫敷料Fixation固定Oftennotneededduetoadhesivebordersofdressingpads由于敷料墊具有粘性邊緣通常不需要固定Fixationwithsemipermeablefilms,siliconecoatedfilmsorelasticbandages以半透膜、硅涂層薄膜或彈力繃帶固定慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第25頁!Wounddressings—Hydrocolloiddressings

傷口敷料—水膠體敷料Keyobjectivesforapplication使用的主要目的Supportgranulation有助于肉芽組織形成Absorptionofcelldebris吸收細(xì)胞碎屑Limitedabsorptionofwoundexudate傷口滲出液吸收有限Ensuringamoistwoundenvironment確保濕潤的傷口環(huán)境Protectionagainstexternaleffects保護(hù)傷口防止外部影響慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第26頁!Wounddressings—Hydrocolloiddressings

傷口敷料—水膠體敷料Mainindication主要適應(yīng)癥Lowtomediumamountofwoundexudate少量到中等量的傷口滲出液Abrasions,first-andsseconddegreeburns,decubitus,legulcers擦傷、1度或2度燒傷、褥瘡、腿部潰瘍WoundsinEpithelialisationphase處于上皮形成時期的傷口Asacoverforotherwounddressings(e.g.alginates)作為其他傷口敷料的覆蓋物慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第27頁!Wounddressings—Hydrocolloiddressings

傷口敷料—水膠體敷料Handing操作Someofhydrocolloiddressingshouldhavebodytemperaturewhenapplied在使用時應(yīng)將某些水膠體敷料加熱至體溫Surroundingofwoundneedstobefreeofhair傷口周圍備皮Dressingneedtobeapproximatelyaninchbiggerthanwound敷料應(yīng)當(dāng)大于傷口約1英寸Canstayonwoundupto7days可以在傷口上保留長達(dá)7天Dressingchangerequiredwhengetclosetoborderofdressing當(dāng)凝膠接近敷料邊緣時則需要更換敷料慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第28頁!Wounddressings—Hydrogelamorphousgels

傷口敷料—無定形水凝膠敷料Contraindication禁忌癥Woundpain傷口疼痛Macerationofsurroundingskin周圍皮膚浸漬Exercisecaution注意Sensitivityagainstponentspossible可能會有成分過敏慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第29頁!Wounddressings—Hydrogelamorphousgels

傷口敷料—無定形水凝膠敷料Fixation固定Secondarydressingabsolutelynecessary絕對有必要使用次級敷料固定Hydropolymerorhydrocolloiddressingsincaseofnon-infected,moistwounds對于非感染傷口,可以采用水聚合型敷料或水膠體型敷料加以固定Semipermeablefilmsfordrywounds對于干性傷口，可以采用半透膜固定Sterilepadsornonwovenadhesivesforinfectedwounds對于感染性傷口，可以采用無菌敷料或非編織型膠帶固定慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第30頁!Wounddressings—Hydrogelsheets

傷口敷料—水凝膠片Keyobjectivesforapplication使用的主要目的Superficial,drywoundsarekeptmoist保持淺表、干燥傷口的濕潤Accelerationofcellgrowth促進(jìn)細(xì)胞生長Supportofautolyticdebridement有助于自溶性清創(chuàng)Coolingeffectonburns對于燒傷具有冷卻作用Painreduction減輕疼痛慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第31頁!Wounddressings—Hydrogelsheets

傷口敷料—水凝膠片Mainindication主要適應(yīng)癥Useonpaper/cortisone/olderskin聯(lián)合可的松涂在紙面上用于老年人的皮膚Superficial,cleanabrasion淺表的清潔擦傷Burnsuptosecond-degree直至2度的燒傷Woundsproducinglittleexudate傷口幾乎沒有滲出物Skindonorsites皮膚供體位置慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第32頁!Wounddressings—Hydrogelsheets

傷口敷料—水凝膠片Handing操作Dressingshouldbeapproximatelyaninchbiggerthanwound敷料應(yīng)當(dāng)大于傷口約1英寸Dressingscanbecuttoidealsize可以將敷料剪至適當(dāng)大小Canstayupto7daysonwound(whendressingturnsuncleardressingchangerequired)可以在傷口保留7天以上（當(dāng)敷料變得不透明時，則需要更換敷料）慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第33頁!Wounddressings—silvercontainingwounddressings

傷口敷料—含銀傷口敷料Description說明Wounddressingcoatedwithsilver（e.g.woundcontactllayer,foam.alginate,hydrofiber）傷口敷料涂銀（例如,傷口接觸層、泡沫敷料、藻酸鹽敷料、水性纖維敷料）Useofbactericidalimpactofsilver利用銀離子殺菌Releaseofsilverionswhenincontactwithwoundexudate與傷口滲出液接觸時可以釋放銀離子Silveriseffectiveagainstawiderangeofbacteria銀可以有效對抗多種細(xì)菌慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第34頁!Wounddressings—silvercontainingwounddressings

傷口敷料—含銀傷口敷料Predominateuseinthefollowingphaseofwoundhealing主要應(yīng)用于傷口愈合的以下階段Cleaningoninfectedwounds清潔用于感染性傷口慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第35頁!Wounddressings—silvercontainingwounddressings

傷口敷料—含銀傷口敷料Contraindication禁忌癥Barefibers,bonesormuscles纖維、谷歌、或肌肉裸露Exercisecaution注意Sensitivityagainstponents對成分過敏Silvershouldonlybeusedaslongasindicated只要有過敏表現(xiàn)不能直接使用Releaseofsilverionsnotsufficientondrywounds在干性傷口上銀離子不能充分釋放慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第36頁!Fixation固定Dependsoninformationofproductionpanies按照產(chǎn)品公司所提供的信息進(jìn)行固定Wounddressings—silvercontainingwounddressings

傷口敷料—含銀傷口敷慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第37頁!Wounddressings—Nonwoven(aborbent)padswithsuperabsorber

傷口敷料—具有強(qiáng)力吸收劑的無紡布（吸收墊料）Description說明Nonwovenpadcontaining/surroundingsuperabsorber無紡布墊料，含有強(qiáng)力吸收劑Canabsorbhighamountofliquids可以吸收大量液體Bacteriaandcelldebriscanbeabsorbed可以吸收細(xì)菌和壞死物Moistwoundclimateiskept保持濕潤的傷口環(huán)境Smellisbound限制傷口異味慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第38頁!Wounddressings—Nonwoven(aborbent)padswithsuperabsorber

傷口敷料—具有強(qiáng)力吸收劑的無紡布（吸收墊料）Mainindication主要適應(yīng)癥Onwoundsthatproducehighamountofexudate(pressure,legulcer,etc.)傷口產(chǎn)生大量滲出液（壓迫性潰瘍、腿部潰瘍等）Contraindication禁忌癥Ondrywoundsriskthatpadstickstothewound(canharmnewganulatedtissue)干性傷口具有墊料粘附傷口的風(fēng)險（可損害新生肉芽組織）慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第39頁!Wounddressings—Nonwoven(aborbent)padswithsuperabsorber

傷口敷料—具有強(qiáng)力吸收劑的無紡布（吸收墊料）Description說明Widelyvarietyavailable應(yīng)用廣泛Madeofseverallayers由數(shù)層構(gòu)成Cancontainadditionalmaterialslikeanabsorptionpad可以包含附加材料，如吸收墊料Bindssmell限制異味Whenindirectedcontactwithwounditbindsproteinmoleculesandbacteria在直接接觸傷口時可以與蛋白質(zhì)分子以及細(xì)菌相結(jié)合Predominateuseinfollowingphasesofwoundhealing主要應(yīng)用于傷口愈合的以下階段Cleansing:oninfected,badlysmellingwounds清潔：用于感染傷口、具有嚴(yán)重異味的傷口慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第40頁!Wounddressings—Activecoaldressings

傷口敷料—活性碳敷料Description說明Semipermeable,polyurethanefilm半透明、聚氨酯甲酸酯薄膜Woundprotection,fixationmaterial傷口保護(hù)型固定材料Barriertobacteria阻擋細(xì)菌Enablesmonitoringofwound能都進(jìn)行傷口監(jiān)護(hù)Naabsorptioncapacity無吸收能力Atraumaticdressingchange非創(chuàng)傷性換藥Predominateuseinfollowingphasesofwoundhealing主要應(yīng)用于傷口愈合的以下階段Epithelialisation:asprimarywounddressing上皮形成階段：作為主要的傷口敷料Fixationofotherdressinginallphasesofwoundhealing在傷口愈合階段固定其他敷料慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第41頁!Wounddressings—Transparentfilmdressings

傷口敷料—透明薄膜敷料Handing操作Materialcanbeoptimalsize材料可被剪裁成最佳尺寸Atraumaticdressingchangethrough非創(chuàng)傷性換藥Overstretchingoffilm薄膜過度拉伸Fixation固定Noadditionalfixationrequired不需要額外固定Usedasfixationforotherwounddressings作為其他敷料的固定物使用慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第42頁!Wounddressings—Hyaluronanwoundtreatment

傷口敷料—透明質(zhì)酸型傷口護(hù)理材料Mainindication主要適應(yīng)癥Acutewoundsproducinghighamountofexudate產(chǎn)生大量滲出液的急性傷口Deep,underminedwounds潛行的深部傷口Skindonorsites皮膚供體部位Chronic,difficulthealingwounds慢性難愈合性傷口Contraindication禁忌癥Clinicinfectedwounds臨床感染性傷口Drynecrosis干性壞死Combinationwithantiseptics與消毒劑聯(lián)合使用Sensitivitytoponents對成分過敏慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第43頁!Wounddressings—Hydrocapillarydressings

傷口敷料—毛細(xì)管吸水型敷料Description說明Woundpadonthebasisofcellulosewithsuperabsorber(polyacrylate)傷口墊采用纖維素和超強(qiáng)吸水劑（聚丙烯酸酯）為基礎(chǔ)Highabsorptioncapacity吸收能力高Supportofgranulation有助于肉芽形成Protectionagainstexternaleffects保護(hù)傷口防止外部影響Availablewithandwithoutadhesiveborders可采用有或無粘性邊緣的敷料Predominateuseinfollowingphasesofwoundhealing主要應(yīng)用于傷口愈合的以下階段Cleanign清潔Ganulation肉芽形成慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第44頁!Wounddressings—Hydrocapillarydressings

傷口敷料—毛細(xì)管吸水型敷料Handing操作Surroundingskinmustbefreeofhair周圍皮膚必須沒有毛發(fā)Dressingshouldbeaboutaninchbiggerthanwound敷料應(yīng)當(dāng)大于傷口約1英寸Useadditionalprimarymaterialondeepwounds,woundswithalotfibrinormoistnecroticwounds深部傷口、含纖維蛋白傷口或濕性壞死傷口額外使用初級材料Canstayupto7daysonwound在傷口上保留長達(dá)7天Fixation固定Nocoverrequired不需要覆蓋物Additionalfixationpossiblewithsemipermeablefilmornonwovenadhesive可以采用半透膜或非編織型膠帶進(jìn)行額外固定慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第45頁!Wounddressings—collagenwounddressings

傷口敷料—膠原型傷口敷料Mainindication主要適應(yīng)癥Chronicandsecondaryhealing,noninfectedwounds慢性及二級愈合傷口Stagnatingwounds停滯傷口Controindication禁忌癥Necroticwounds壞死性傷口Infectedwounds感染性傷口慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第46頁!Wounddressings—

Opencelllformdressings

傷口敷料—開孔式泡沫敷料Description說明Polyurethaneorpolyvinylalcoholfoam聚氨酯甲苯酸或聚乙烯醇泡沫Opencellsurface開孔表面Usedforwoundconditioning需要對粉劑進(jìn)行濕化Adhesivetightlytothewound與傷口緊密粘合Mechanicaldebridementatdressingchange(painful)更換敷料時需要進(jìn)行機(jī)械清創(chuàng)（疼痛）Woundscleaningofinfected,secondaryhealingwounds需要對感染性次級愈合傷口進(jìn)行清潔Limitedabsorptionofexudateandcelldebris吸收滲出物和細(xì)胞碎屑能力有限Goodoxygenandwatervapourpermeability氧氣和水蒸氣滲透性良好Predominantuseinfollowingphasesofwoundhealing主要用于傷口愈合的以下階段Granulation肉芽形成慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第47頁!Wounddressings—

Opencelllformdressings

傷口敷料—開孔式泡沫敷料Handing操作Cuttooptimalfit剪裁成最佳的適用尺寸Placeflatonwound平放在傷口上Dressingchangeafter12to48hours(dependsonamountofexudate)12到48小時后更換敷料Fixation固定Nonwovenfixationmaterialorelasticbandage無紡布材料或彈性材料Lightpressioncanbereachedthroughadditionalpadsbetweenfoamandfixatin通過敷料和固定物之間的額外墊料可以實現(xiàn)壓迫慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第48頁!Woundcleaning傷口清潔

Ways方法Basiccleanningofwoundbed,woundedgesandsurroundingarea對傷口創(chuàng)面、邊緣以及周圍進(jìn)行基本清洗Antibacteiracleanning抗菌劑清洗Woundrinsing傷口沖洗WoundcleaningWettodry干燥清洗傷口Debridement清創(chuàng)術(shù)Negtivepressure負(fù)壓

慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第49頁!Woundcleaning傷口清潔

----技術(shù)Cleanningwithantisepticsolution采用消毒溶液進(jìn)行清洗Octenidin-di-hydrochlorid奧替尼啶鹽酸化合物Polyhexanid聚已縮胍Iodine碘Indication:Infectedandcontaminatedwound適應(yīng)癥：感染傷口和污染傷口Nontouchtechnique:Fromoutsidetocenterofwoundinordertoavoidfurtherspreadingofbacteriatothesurroundingarea.非接觸技術(shù)：從外圍向中間清洗以避免細(xì)菌向周圍進(jìn)一步播散慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第50頁!Woundcleaning--Antisepticsolution

傷口清潔--消毒溶液IodineAdvantages優(yōu)點EffevtiveagainstGrampostiveandGramnegtivebacteria可有效對抗革蘭陽氏和陰性菌Availableindifferentformsforapplication(ointment,lotions)可以采用不同形式加以運(yùn)用（軟膏、洗液）Disadvantages缺點Colored(makeswoundassessmentdifficult)有色（難以對傷口進(jìn)行評估）Inactivatedbybodyfluids會被體液滅活Sensitivitymightoccur可能會發(fā)生過敏Systemicsideeffectsduetoabsortion吸收會導(dǎo)致全身副作用慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第51頁!Debridementopportunity清創(chuàng)時機(jī)病情許可，越早越好Illnesspermission,thesooner,thebetter無明顯感染表現(xiàn)，均可清創(chuàng)Noapparentinfection,debridementperformance已有感染，但傷口有異物或較多壞死組織，也可清創(chuàng)，清創(chuàng)后傷口暫不縫合IftheWoundisinfected,buthaveaforeignbodyormuchnecrotictissue,wecanalsodebridement,anddonotwoundclosureafterdebridement急性傷口理想時間：傷后8小時以內(nèi)，頭面、手部傷口12小時以內(nèi)Theidealtime:8hoursafterthewound,andthehead,handwithin12hoursafterthewound慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第52頁!Wounddebridemen清創(chuàng)術(shù)Mechanical機(jī)械性清創(chuàng)Wipe(mechancialyclean)thewoundwithsterilegauze無菌紗布擦拭傷口（機(jī)械型清洗）Gauzecanbemoistordry可以采用濕性或干性紗布Cave:mightbepainfulforpatient孔洞：可能造成患者疼痛Aternative選擇Soakedgauzeisappliedtowoundandshouldberemovedgently.Everytimesomeofwounddebriswillremainingauze.對傷口使用浸濕紗布，而且去除紗布時動作應(yīng)當(dāng)輕柔。每次都會有一些傷口碎屑留在紗布內(nèi)。慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第53頁!Wounddebridemen清創(chuàng)術(shù)Enzymatic酶解清創(chuàng)術(shù)Removalofdebriswithemzymes采用酶法Havetoberenewedfrequently必須經(jīng)常更新Needamoistandbodywarmenvironmenttobeeffective需要保肢潮濕和體溫環(huán)境才能產(chǎn)生作用Havetobeappliedattheareaofdebris必須在清創(chuàng)區(qū)域使用CollegesSanty1Z**Ointment(膠原酶Santy1)Enzymaticdebridingagent(清創(chuàng)酶)慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第54頁!Wounddebridement清創(chuàng)術(shù)Autolytic自熔性清創(chuàng)術(shù)Facilitatebodyownsofmechanismofdebridementmoistdressing采用適當(dāng)?shù)臐裥苑罅洗龠M(jìn)機(jī)體自身清創(chuàng)機(jī)制Advantage優(yōu)點Cellfriendly細(xì)胞親和性Almostpainfree幾乎無痛Easytodo容易操作Disadvantage缺點Tasksmoretimethanforinstancesurgicaldebridement比手術(shù)清創(chuàng)方法花費(fèi)更多時間Needstobeadaptedtotheindividualrequirementsofwound需要適合傷口的個體要求Notalwayseffectiveforinstanceincaseofthicknecroticlayer在諸如壞死層較厚的情況下慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第55頁!Wounddressings-General

傷口敷料—總體Requirements要求Maintainmoistenvironment保持環(huán)境濕潤Sterile無菌Removeexcessexudate去除多余滲出物Nontoxic無毒性Nonsenstizing無過敏性Protectthewoundfromfurthertrauma保護(hù)傷口防止進(jìn)一步損傷Allownontraumaticremoval去除時不會產(chǎn)生損傷Protectfrommigrationofbacteria保護(hù)傷口防止細(xì)菌遷移Keepwoundatbodytemperature(Isulation)保護(hù)傷口處于體溫下（絕緣）Allowgaseousexchange允許空氣交換Comfortable舒適Economical/requireinfrequentchanges經(jīng)濟(jì)/不需要經(jīng)常更換慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第56頁!Wounddressings-Requirements

傷口敷料—要求Keyfunctions主要作用Keepwoundbedmoist保持創(chuàng)面濕潤Keepwoundsurroundingskindry保持傷口周圍皮膚干燥Avoidcoolingdownofwoundtemperature避免傷口溫度降低Protectfrominfection預(yù)防感染Shouldnotleaveresidualsinwound傷口內(nèi)不應(yīng)留下殘余物慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第57頁!Wounddressings-Requirements

傷口敷料—要求Occlusiveornonocclusivedressings封閉型或非封閉型敷料Occlusiveenvironmentissupportiveforwoundhealing封閉環(huán)境有助于傷口愈合Attention注意Incaseofinfection,severecontaminationexposedtendon,bone,fistualsanocclusioncanbedangerous.在肌腱、骨骼暴露以及瘺管存在感染或嚴(yán)重感染時，封閉可能具有危險Keepwoundsurroundingskindry保持傷口周圍皮膚干燥慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第58頁!Wounddressings-Wettherapy(TenderWet)

傷口敷料—濕潤療法（德濕威TenderWetKeyobjectivesforapplication使用的主要目的Hydrationofwoundbedfor24hours使創(chuàng)面保濕24小時Initiationandsupportofautolyticdebridement引發(fā)或有助于自溶性清創(chuàng)ReleaseofRingersolutionintowoundbed將林格氏液釋放至創(chuàng)面Absorptionofwoundexudate吸收傷口滲出液慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第59頁!Wounddressings-Wettherapy(TenderWet)

傷口敷料—濕潤療法（德濕威TenderWet）Mainindication主要適應(yīng)癥Infectedwounds(deepandsuperficial)感染傷口（深部和表淺）Necroticwounds(deepandsuperficial)壞死傷口（深部和表淺）Woundswithstagnatinghealing愈合停止的傷口慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第60頁!Wounddressings-Wettherapy(TenderWet)

傷口敷料—濕潤療法（德濕威TenderWet）Handing操作Protectwoundsurroundingarea保護(hù)傷口周圍區(qū)域Mustbechangedafter24hours24小時后必須更換GreenstripesofTenderWet24arefacingawayfromwoundbed在創(chuàng)面使用德濕威24時，應(yīng)將綠色條紋面朝外。Dressingmustnotbecut不要對敷料進(jìn)行裁減慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第61頁!Wounddressings—Alginates

傷口敷料—藻酸鹽類敷料Alginatefromoriginatefrombetweenalgae海藻纖維源于褐藻Alginateturnintogetwhenincontactwithwoundexudate藻酸鹽類敷料與傷口接觸時可變成凝膠Alginatescanabsorbasignificantamountmorethantheirweightofwoundfluids藻酸鹽類敷料可以吸收顯著高于其自身重量的傷口滲出液慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第62頁!Wounddressings—Alginates

傷口敷料—藻酸鹽類敷料Predominateuseinfollowingphasesofwoundhealing主要應(yīng)用于傷口愈合的以下階段Cleaning清潔Granulation肉芽形成Especiallyfordeepsmallcavitywounds尤其用于較深而且較小的孔腔性潰瘍Rarely很少慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第63頁!Wounddressings—Alginates

傷口敷料—藻酸鹽類敷料Contraindication禁忌癥Dryorcrustedwounds干燥或結(jié)痂傷口Drynecrosis干性壞死Third-degreeburnsorhigher3度或3度以上燒傷Exercisecaution注意Pressurereleaseswoundexudateagain壓力解除傷口會再次滲出RemoveAlginatesresidual-free去除藻酸鹽類敷料時不應(yīng)留有殘余（dangerofinfection）(具有危害性或感染性)Donotapplywithpressure不應(yīng)加壓使用Avoidoverlappingwoundedges避免與傷口邊緣重疊慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第64頁!Wounddressings—Hydrofiberdressings

傷口敷料—親水性材料Description說明Madeof“Natriumcarboxymethycellulose”由羧甲基纖維素制成Highabsorptioncapacity吸收性能較高Turnsintotransparentgetwhenincontactwithwoundexudate垂直吸收創(chuàng)面滲出液慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第65頁!Wounddressings—Hydrofiberdressings

傷口敷料—親水性材料Mainindication主要適應(yīng)癥Highlysecretingwounds高分泌型傷口Acuteandchronicwounds急性和慢性傷口Postoperativewounds術(shù)后傷口First–andsecond-degreeburns1度或2度燒傷Incaseofproblematic(indangertodevelopmaceration)surroundskin用于傷口周圍皮膚存在問題的情況下（具有發(fā)展成浸漬傷口的危險）慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第66頁!Wounddressings—Hydrofiberdressings

傷口敷料—親水性材料Handling操作Dressingmaydevelopthewoundbyabout1inch敷料可以在傷口上重疊約1英寸厚Hydrofibertamponadesshouldbepokeoutofthewoundbyapproximatelyaninch水性纖維敷料填塞應(yīng)高于傷口約1英寸慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第67頁!Wounddressings—Polyurethane/Foamdressings

傷口敷料—聚氨酯/泡沫敷料Description說明Madeofafine(Polyurethane)foamcoveredwithasemiocclusivePolyurethanefilm由覆蓋一層封閉型聚氨基甲酯薄膜的精制泡沫構(gòu)成Foamdressingshavehighabsorption泡沫敷料具有高度吸水性Airpermeablemembraneenablesgasexchange空氣可以滲入薄膜使氣體得以交換Availablewithandwithoutadhesive可以和膠帶一起應(yīng)用，也可以單獨(dú)使用慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第68頁!Wounddressings—Polyurethane/Foamdressings

傷口敷料—聚氨酯/泡沫敷料Mainindication主要適應(yīng)癥Exudatingwounds滲出性傷口Ascavityindeep,underminedexudatingwounds孔腔較深的潛行性滲出傷口Inbinationwithpressiontherapy聯(lián)合加壓治療Onslushy,fibrincoatedwounds膠凍狀纖維蛋白覆蓋性傷口慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第69頁!Wounddressings—Polyurethane/Foamdressings

傷口敷料—聚氨酯/泡沫敷料Handing操作Cavityproductsfordeepwounds孔腔產(chǎn)品用于深部傷口Dressingshouldbeoverlapping敷料應(yīng)當(dāng)重疊使用Dressingscansometimesbecuttofittingsize有時可將敷料裁剪成適當(dāng)大小Canstayonwoundupto7days(dependingonamountofwoundexudate)可以在傷口保留長達(dá)7天（依據(jù)傷口滲出液的量）慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第70頁!Wounddressings—Hydrocolloiddressings

傷口敷料—水膠體敷料Description說明Semioclusive,madeofwater-repellingpolymermatrix(thinpolyurethanefilm)半封閉型采用防水性聚合物基質(zhì)形成（聚氨酯薄膜）Matrixcontainshydrocolloidsubstance基質(zhì)包含親水物質(zhì)Sometimeswithadhesivenonwovenboardersorflatterboardersforeasyapplication有時存在便于使用的粘性非編織性邊緣或更為平整的粘性邊緣慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第71頁!Wounddressings—Hydrocolloiddressings

傷口敷料—水膠體敷料Predominateuseinfollowingphasesofwoundhealing主要應(yīng)用于傷口愈合的以下階段Cleansing清潔Granulation肉芽形成Epithelialisation上皮形成慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第72頁!Wounddressings—Hydrocolloiddressings

傷口敷料—水膠體敷料Contraindication禁忌癥Deepmycosis深部真菌病Highlyexudingorbleedingwounds高度滲血或出血傷口Third–orforth-degreeburns3度或4度燒傷Osteomyelitis骨髓炎Deepwoundswithbarebones,muscles,tendons深部傷口伴谷歌、肌肉、肌腱裸露Exercisecaution注意Macerationofsurroundingskinpossible傷口具有浸漬可能Hypergranulation肉芽組織過度形成Diabeticfootulcers糖尿病性足部潰瘍慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第73頁!Wounddressings—Hydrocolloiddressings

傷口敷料—水膠體敷料Fixation固定Nosecondarydressingorfixationneeded不需要次級敷料或固定

Hydrocolloiddressingsareoftenusedasfixationforotherwounddressings水膠體敷料通常最為其他敷料的固定物Ifneededfurtherfixationwithadhesiveproductslikefilmsect,possible如果需要，可以采取注入膠帶之類的產(chǎn)品進(jìn)行固定慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第74頁!Wounddressings—Hydrogelamorphousgels

傷口敷料—無定形水凝膠敷料Handing操作Applicationof0.3to0.5cmofgelonwound在傷口上使用0.3到0.5cm的凝膠Protectionofsurroundingskinnecessarytoavoidmaceration有必要對周圍皮膚進(jìn)行保護(hù)以免發(fā)生浸漬RinsingofwoundwithRingersolutionorsalinetoremoveresidues采用林格氏液或生理鹽水沖洗去除殘余凝膠慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第75頁!Wounddressings—Hydrogelsheets

傷口敷料—水凝膠片Description說明Semiolcusive,transparentdressings半封閉性、透明敷料Applicationdirectlyonwound直接用于傷口Keepwoundmoist保持傷口濕潤Allowinspectionofwoundthroughdressing可以通過敷料檢查傷口Canstayseveraldaysonwound可以在傷口保留數(shù)日Reducepain減輕疼痛Smallamountofexudatecanbeabsorbed可以吸收少量滲出液Contain15-95%waterbutarenotabsolutelyinwater含15-95%水分但不溶于水Cushioningeffect緩沖作用慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第76頁!Wounddressings—Hydrogelsheets

傷口敷料—水凝膠片Predominateuseinfollowingphasesofwoundhealing主要應(yīng)用于傷口愈合的以下階段CleaningRehydrateseschar，supportautolyticmechanisms清潔再次水化焦痂、有助于自溶機(jī)制Granulationprotects肉芽形成保護(hù)

Epithelialisationpreventsdessication上皮形成防止干燥慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第77頁!Wounddressings—Hydrogelsheets

傷口敷料—水凝膠片Contraindication禁忌癥Escharduetoarterialulceration因動脈性可以所導(dǎo)致的焦痂Strongexudatiionorbleeding大量滲出液或出血Deepwounds,mycosis傷口較深或真菌病Sheetsshouldnotbeusedoninfectedwounds水凝膠片不用于感染性傷口

Exercisecaution注意Sensitivitytoponentspossible可能對成分過敏慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第78頁!Wounddressings—Hydrogelsheets

傷口敷料—水凝膠片F(xiàn)ixation固定Productswithadhesivebordersdon’trequireadditionalfixation帶有粘性邊緣的產(chǎn)品不需要額外固定Otherwisefixationwithgauzebandageornonwovenadhesives否則采用紗布或非編織型膠帶固定慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第79頁!Wounddressings—silvercontainingwounddressings

傷口敷料—含銀傷口敷料Keyobjectivesforapplication使用的主要目的Killingofbacteria殺滅細(xì)菌Wideeffectivenessagainstmicroorganisms(Saphylococcusaureus,Pseudomonas,MRSA,etc.)廣譜對抗微生物（金黃色葡萄球菌、假單胞菌、MRSA等）慢性傷口處理共94頁，您現(xiàn)在瀏覽的是第80頁!Wounddressings—silvercontainingwounddressings

傷口敷料—含銀傷口敷料Mainindication主要適應(yīng)癥Secon