慢性傷口處理.ppt

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Breadinggroundforbacteriaandcomponentswhichmightbesupportivetothedevelopmentofbiofilms.細(xì)菌滋養(yǎng)環(huán)境以及可能會(huì)促進(jìn)生物被膜形成的成分,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）,Woundcleaning-Techniques傷口清潔-技術(shù),Requirementsonwoundrinsingsolutions對(duì)傷口沖洗液的要求Shouldbesterilie無(wú)菌Notcolored無(wú)色Genteltocells/nontoxic細(xì)胞溫和型/無(wú)毒Bodytemperature(coolingdownwoundbedreducesorinactivatescellactivity)28nofunction體溫（冷卻創(chuàng)面、減少細(xì)胞活性或使其滅活）28無(wú)效,Woundcleaning傷口清潔,Ways方法Basiccleanningofwoundbed,woundedgesandsurroundingarea對(duì)傷口創(chuàng)面、邊緣以及周?chē)M(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,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),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?chē)M(jìn)一步播散,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(diǎn)notcolored,notinacticatedbybodyfluids無(wú)色、不會(huì)被體液滅活donotinitiateresistance,skinirritationandallergies不會(huì)引起抗藥性、皮膚刺激或過(guò)敏Disadvantages缺點(diǎn)notavailableandreimbursedinmanycountries在許多地區(qū)不能使用而且不能報(bào)銷(xiāo)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）,Woundcleaning-Antisepticsolution傷口清潔-消毒溶液,IodineAdvantages優(yōu)點(diǎn)EffevtiveagainstGrampostiveandGramnegtivebacteria可有效對(duì)抗革蘭陽(yáng)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(diǎn)Colored(makeswoundassessmentdifficult)有色（難以對(duì)傷口進(jìn)行評(píng)估）Inactivatedbybodyfluids會(huì)被體液滅活Sensitivitymightoccur可能會(huì)發(fā)生過(guò)敏Systemicsideeffectsduetoabsortion吸收會(huì)導(dǎo)致全身副作用,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,Debridementopportunity清創(chuàng)時(shí)機(jī),病情許可，越早越好Illnesspermission,thesooner,thebetter無(wú)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(shí)間：傷后8小時(shí)以?xún)?nèi)，頭面、手部傷口12小時(shí)以?xún)?nèi)Theidealtime:8hoursafterthewound,andthehead,handwithin12hoursafterthewound,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(lèi)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(lèi)）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,Wounddebridemen清創(chuàng)術(shù),Mechanical機(jī)械性清創(chuàng)Wipe(mechancialyclean)thewoundwithsterilegauze無(wú)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(duì)傷口使用浸濕紗布，而且去除紗布時(shí)動(dòng)作應(yīng)當(dāng)輕柔。每次都會(huì)有一些傷口碎屑留在紗布內(nèi)。,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(huì)引起患者疼痛Chanceofbleeding可能會(huì)出血InseverecasesintmustbeconductedinOR嚴(yán)重時(shí)必須采用手術(shù)進(jìn)行處理,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),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(diǎn)Veryselectivecleaning/Antisepticeffect選擇性清潔/防腐作用Stimulategranulation刺激肉芽生長(zhǎng)Almostpainfree幾乎無(wú)痛Disadvantage缺點(diǎn)Notalwayseasytoapplyandkeepinplace不容易使用而且不容易固定。Ethicalaspectsneedconsideration.需要對(duì)倫理學(xué)方面加以考慮。,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(diǎn)Cellfriendly細(xì)胞親和性Almostpainfree幾乎無(wú)痛Easytodo容易操作Disadvantage缺點(diǎn)Tasksmoretimethanforinstancesurgicaldebridement比手術(shù)清創(chuàng)方法花費(fèi)更多時(shí)間Needstobeadaptedtotheindividualrequirementsofwound需要適合傷口的個(gè)體要求Notalwayseffectiveforinstanceincaseofthicknecroticlayer在諸如壞死層較厚的情況下,Theevolutionandapplicationofdressings,GauzeOilYam、stickingHydrocolloiddressingsAntibacterialdressings,干紗布油砂、敷貼水膠體抗菌敷料、生物活性敷料,Wounddressings-General傷口敷料總體,Requirements要求Maintainmoistenvironment保持環(huán)境濕潤(rùn)Sterile無(wú)菌Removeexcessexudate去除多余滲出物Nontoxic無(wú)毒性Nonsenstizing無(wú)過(guò)敏性Protectthewoundfromfurthertrauma保護(hù)傷口防止進(jìn)一步損傷Allownontraumaticremoval去除時(shí)不會(huì)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,Wounddressings-Requirements傷口敷料要求,Keyfunctions主要作用Keepwoundbedmoist保持創(chuàng)面濕潤(rùn)Keepwoundsurroundingskindry保持傷口周?chē)つw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,Wounddressings-Requirements傷口敷料要求,Keyfunctions主要作用Keepwoundbedmoist保持創(chuàng)面濕潤(rùn)Keepwoundsurroundingskindry保持傷口周?chē)つw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,Wounddressings-Differentkinds,Criteriaforselection選擇標(biāo)準(zhǔn)Woundsite傷口位置Exudate滲出物Signsofinfection感染跡象Conditionofwoundsurroundingskin傷口周?chē)つw狀況Pain疼痛,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(shí)，封閉可能具有危險(xiǎn)Keepwoundsurroundingskindry保持傷口周?chē)つw干燥,Wounddressings-Wettherapy(TenderWet)傷口敷料濕潤(rùn)療法（德濕威TenderWet）,Description說(shuō)明Hydroactivedressingpadforwettherapy采用水活化性敷料墊用于濕潤(rùn)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。,Wounddressings-Wettherapy(TenderWet)傷口敷料濕潤(rùn)療法（德濕威TenderWet,Keyobjectivesforapplication使用的主要目的Hydrationofwoundbedfor24hours使創(chuàng)面保濕24小時(shí)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,Wounddressings-Wettherapy(TenderWet)傷口敷料濕潤(rùn)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,Wounddressings-Wettherapy(TenderWet)傷口敷料濕潤(rùn)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,Wounddressings-Wettherapy(TenderWet)傷口敷料濕潤(rùn)療法（德濕威TenderWet）,Contraindication禁忌癥Escharduetountreatedarterialulceration由未經(jīng)治療的動(dòng)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,Wounddressings-Wettherapy(TenderWet)傷口敷料濕潤(rùn)療法（德濕威TenderWet）,Handing操作Protectwoundsurroundingarea保護(hù)傷口周?chē)鷧^(qū)域Mustbechangedafter24hours24小時(shí)后必須更換GreenstripesofTenderWet24arefacingawayfromwoundbed在創(chuàng)面使用德濕威24時(shí)，應(yīng)將綠色條紋面朝外。Dressingmustnotbecut不要對(duì)敷料進(jìn)行裁減,Wounddressings-Wettherapy(TenderWet)傷口敷料濕潤(rùn)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。,WounddressingsAlginates傷口敷料藻酸鹽類(lèi)敷料,Alginatefromoriginatefrombetweenalgae海藻纖維源于褐藻Alginateturnintogetwhenincontactwithwoundexudate藻酸鹽類(lèi)敷料與傷口接觸時(shí)可變成凝膠Alginatescanabsorbasignificantamountmorethantheirweightofwoundfluids藻酸鹽類(lèi)敷料可以吸收顯著高于其自身重量的傷口滲出液,WounddressingsAlginates傷口敷料藻酸鹽類(lèi)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,WounddressingsAlginates傷口敷料藻酸鹽類(lèi)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,WounddressingsAlginates傷口敷料藻酸鹽類(lèi)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,WounddressingsAlginates傷口敷料藻酸鹽類(lèi)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(huì)再次滲出RemoveAlginatesresidual-free去除藻酸鹽類(lèi)敷料時(shí)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,WounddressingsAlginates傷口敷料藻酸鹽類(lèi)敷料,Fixation固定Alginatesneedtobecoveredbyasecondarydressing藻酸鹽類(lèi)敷料需要采用次級(jí)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,WounddressingsHydrofiberdressings傷口敷料親水性材料,Description說(shuō)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,WounddressingsHydrofiberdressings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(compressiontherapy)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,WounddressingsHydrofiberdressings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Firstandsecond-degreeburns1度或2度燒傷Incaseofproblematic(indangertodevelopmaceration)surroundskin用于傷口周?chē)つw存在問(wèn)題的情況下（具有發(fā)展成浸漬傷口的危險(xiǎn)）,WounddressingsHydrofiberdressings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,WounddressingsHydrofiberdressings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,WounddressingsHydrofiberdressings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(jí)敷料加以覆蓋Absorbingpads、gauzebandagesornonwovenfixationproducts吸收墊、紗布繃帶或非編織性產(chǎn)品,WounddressingsPolyurethane/Foamdressings傷口敷料聚氨酯/泡沫敷料,Description說(shuō)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,WounddressingsPolyurethane/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(shí)可以用于感染性傷口（無(wú)粘性邊緣）Granulation肉芽形成Epithellialisation上皮形成thinfoamdressingonly只采用薄層泡沫敷料,WounddressingsPolyurethane/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Incombinationwithcompressiontherapy聯(lián)合加壓治療Onslushy,fibrincoatedwounds膠凍狀纖維蛋白覆蓋性傷口,WounddressingsPolyurethane/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.OnlyasacoverincombinationwithforinstanceHydrogelwound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(shí)具有浸漬的可能,WounddressingsPolyurethane/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(shí)可將敷料裁剪成適當(dāng)大小Canstayonwoundupto7days(dependingonamountofwoundexudate)可以在傷口保留長(zhǎng)達(dá)7天（依據(jù)傷口滲出液的量）,WounddressingsPolyurethane/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,WounddressingsHydrocolloiddressings傷口敷料水膠體敷料,Description說(shuō)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(shí)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,WounddressingsHydrocolloiddressings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(rùn)的傷口環(huán)境Protectionagainstexternaleffects保護(hù)傷口防止外部影響,WounddressingsHydrocolloiddressings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,WounddressingsHydrocolloiddressings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(shí)期的傷口Asacoverforotherwounddressings(e.g.alginates)作為其他傷口敷料的覆蓋物,WounddressingsHydrocolloiddressings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Thirdorforth-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(guò)度形成Diabeticfootulcers糖尿病性足部潰瘍,WounddressingsHydrocolloiddressings傷口敷料水膠體敷料,Handing操作Someofhydrocolloiddressingshouldhavebodytemperaturewhenapplied在使用時(shí)應(yīng)將某些水膠體敷料加熱至體溫Surroundingofwoundneedstobefreeofhair傷口周?chē)鷤淦ressingneedtobeapproximatelyaninchbiggerthanwound敷料應(yīng)當(dāng)大于傷口約1英寸Canstayonwoundupto7days可以在傷口上保留長(zhǎng)達(dá)7天Dressingchangerequiredwhengetclosetoborderofdressing當(dāng)凝膠接近敷料邊緣時(shí)則需要更換敷料,WounddressingsHydrocolloiddressings傷口敷料水膠體敷料,Fixation固定Nosecondarydressingorfixationneeded不需要次級(jí)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(lèi)的產(chǎn)品進(jìn)行固定,WounddressingsHydrogelamorphousgels傷口敷料無(wú)定形水凝膠敷料,Contraindication禁忌癥Woundpain傷口疼痛Macerationofsurroundingskin周?chē)つw浸漬Exercisecaution注意Sensitivityagainstcomponentspossible可能會(huì)有成分過(guò)敏,WounddressingsHydrogelamorphousgels傷口敷料無(wú)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(duì)周?chē)つw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,WounddressingsHydrogelamorphousgels傷口敷料無(wú)定形水凝膠敷料,Fixation固定Secondarydressingabsolutelynecessary絕對(duì)有必要使用次級(jí)敷料固定Hydropolymerorhydrocolloiddressingsincaseofnon-infected,moistwounds對(duì)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(duì)于干性傷口，可以采用半透膜固定Sterilepadsornonwovenadhesivesforinfectedwounds對(duì)于感染性傷口，可以采用無(wú)菌敷料或非編織型膠帶固定,WounddressingsHydrogelsheets傷口敷料水凝膠片,Description說(shuō)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(rùn)Allowinspectionofwoundthroughdressing可以通過(guò)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,WounddressingsHydrogelsheets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(rùn)Accelerationofcellgrowth促進(jìn)細(xì)胞生長(zhǎng)Supportofautolyticdebridement有助于自溶性清創(chuàng)Coolingeffectonburns對(duì)于燒傷具有冷卻作用Painreduction減輕疼痛,WounddressingsHydrogelsheets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,WounddressingsHydrogelsheets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(méi)有滲出物Skindonorsites皮膚供體位置,WounddressingsHydrogelsheets傷口敷料水凝膠片,Contraindication禁忌癥Escharduetoarterialulceration因動(dòng)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Sensitivitytocomponentspossible可能對(duì)成分過(guò)敏,WounddressingsHydrogelsheets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(shí)，則需要更換敷料）,WounddressingsHydrogelsheets傷口敷料水凝膠片,Fixation固定Productswithadhesivebordersdontrequireadditionalfixation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,Wounddressingssilvercontainingwounddressings傷口敷料含銀傷口敷料,Description說(shuō)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(shí)可以釋放銀離子Silveriseffectiveagainstawiderangeofbacteria銀可以有效對(duì)抗多種細(xì)菌,Wounddressingssilvercontainingwounddressings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(duì)抗微生物（金黃色葡萄球菌、假單胞菌、MRSA等）,Wounddressingssilvercontainingwounddressings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,Wounddressingssilvercontainingwounddressings傷口敷料含銀傷口敷料,Mainindication主要適應(yīng)癥Secondaryhealingwoundslikepressureorlegulcer中等愈合傷口如壓迫性潰瘍或腿部潰瘍Tumorwounds,abscess,etc.腫瘤傷口、膿腫等Cleaningwoundswhichareinfected,indangerofinfectionorbadlysmelling對(duì)感染傷口或有感染危險(xiǎn)或嚴(yán)重異味性傷口進(jìn)行傷口清潔,Wounddressingssilvercontainingwounddressings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Sensitivityagainstcomponents對(duì)成分過(guò)敏Silvershouldonlybeusedaslongasindicated只要有過(guò)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,Handing(Dependingontypeofdressing)操作（根據(jù)敷料類(lèi)型）Dressingshouldbeaboutaninchbiggerthanwound敷料應(yīng)當(dāng)高于傷口約1英寸Padsshouldbeeasilyplacedinwound,directedcontactwithwoundbed墊料應(yīng)當(dāng)容易放入傷口，直接與創(chuàng)面接觸IncaseofdryandsuperficialwoundsdressingshouldbementionedwithRingersolutionorSalineofcombinedwithhydogel在干燥且表淺的傷口情況下，應(yīng)當(dāng)采用林格氏液或生