压疮评估与治疗的进展.ppt

Unstageable: Depth Unknown Full thickness tissue loss in which the base of the ulcer is covered by slough (yellow, tan, gray, green or brown) and/or eschar (tan, brown or black) in the wound bed. Until enough slough and/or eschar is removed to expose the base of the wound, the true depth, and therefore Category/Stage, cannot be determined. Stable (dry, adherent, intact without erythema or fluctuance) eschar on the heels serves as ‘the body’s natural (biological) cover’ and should not be removed. Pressure Ulcer Classifications 分级  * ppt课件 Suspected Deep Tissue Injury: Depth Unknown Purple or maroon localized area of discolored intact skin or blood-filled blister due to damage of underlying soft tissue from pressure and/or shear. The area may be preceded by tissue that is painful, firm, mushy, boggy, warmer or cooler as compared to adjacent tissue. Pressure Ulcer Classifications 分级  * ppt课件 Pressure Ulcer Classifications 分级 II期 III期 IV期 不可分期 I期 可疑深部组织受损 * ppt课件 Factors That Affect PU Wound Healing 影响压疮伤口康复的因素包括： PU Wound healing is a complex multifactorial process 压疮的康复是一个 复杂的、多因素的、 缓慢的过程！ Soft Tissue Infection 软组织感染 Systemic Illness 系统性疾病 Osteomyelitis 骨髓炎 Wound Environment 伤口周边环境 Pressure 压力 Oxygen 氧供能力 Perfusion 灌注状况 Systemic Healing Ability 组织的复原能力 Compliance 组织顺应性 Edema 浮肿 Nutrition 营养状况 压疮导致病人疼痛，感染甚至危及病人生命， 治疗昂贵且漫长！压疮的关键工作在于预防！ * ppt课件  Malnutrition and dehydration营养失调和脱水 Diabetes mellitus糖尿病 End-stage renal disease晚期肾脏疾病 Thyroid disease甲状腺疾病 Congestive heart failure充血性心力衰竭 Peripheral Vascular Disease外周血管疾病 Vasculitis/other collagen vascular disorders 血管炎和其他胶原血管疾病 Immune deficiency states免疫缺陷状态 Malignancies恶性肿瘤 COPD 慢性阻塞性肺病 Depression and psychosis精神状态抑郁 Drugs that affect healing药物影响康复 Contractures at major joints关节挛缩 Comorbid Conditions That May Affect Ulcer Healing 多种可能影响压疮康复的身体状况 * ppt课件 The Nonhealing Chronic WoundFailure to Heal by 12 Weeks慢性伤口需要12周的时间才能愈合 - Catabolism 分解代谢 ˉ Catabolism 分解代谢 ˉ Anabolism 合成代谢 - Anabolism 合