卫生与敷料.pptVIP

ICW H2 P14 ? Hygiene and dressing change Microbial Progression in Wounds 伤口内细菌侵袭的过程 Contamination 污染 (host control 宿主控制） Colonization 定植 (established microbial population, host control, microbial balance微生物数量确定，宿主控制，菌群平衡） Critical Colonization 严重定植 (established microbial population,wound not progressing, microbialimbalance, no signs of infection微生物数量确定， 没有进展，菌群失衡，没有明显的感染症状) Topical antiseptic agent 局部杀菌剂 Infection 感染 (microbial control 细菌控制) Systemic antibiotics topical antiseptic agents 全身抗生素和局部杀菌剂 宿主抵抗 ICW H2 P14 ? Hygiene and dressing change Contaminated wounds 污染性伤口 Bacteria present within the wound 细菌存在于伤口中 Not multiplying 没有复制 Steady state of replicating organisms that maintain a presence but do not cause delayed wound healing 未引起伤口的延迟愈合 ICW H2 P14 ? Hygiene and dressing change Critical colonization 严重定植 Bacterial burden in the wound bed increasing细菌数量增加 Initiates body’s immune response locally but not systemically 引起机体局部的免疫反应，但没有全身反应 ICW H2 P14 ? Hygiene and dressing change Infection 感染 Bacterial multiplying. 细菌大量复制 Associated host reaction 引起宿主反应 Body’s immune response will be initiated locally and then systemicall 引起机体全身和局部的免疫反应 ICW H2 P14 ? Hygiene and dressing change Goals of dressing change 更换敷料的目的 Check condition of wound and process of wound healing 检查伤口状况以及伤口的愈合过程。 If necessary adapt wound therapy 如果有必要，则改变伤口治疗方法。 Fight against existing wound infection 积极治疗已经存在的伤口感染。 ICW H2 P14 ? Hygiene and dressing change Avoid pain ( if pain during dressing change can be expected patients should take medication before procedure. Or use topical anesthetizing agent. 患者应当在操作之前服用药物以避免疼痛（如果可以预测到更换敷料的过程中会有疼痛）。或者使用局部麻醉剂。 Goals of dressing change 更换敷料的目的 ICW H2 P14 ? Hygiene and dressing change Basic principles of hygienic dressing change敷料更换的基本卫生原则（一） Use of sterile equipment which has been stored appropriately before use. 采用使用前得到适当储存的无菌设备 Direct contact with susceptible