慢性伤口处理.pptVIP

wound cleaning --Techniques伤口清洁---技术 Components which need to be removed from wound bed 需要从创面去除的部分 Surplus exudate多余渗出物 Necrotic tissue坏死组织 Dead cells 死亡细胞 Breading ground for bacteria and components which might be supportive to the development of biofilms. 细菌滋养环境以及可能会促进生物被膜形成的成分 wound cleaning伤口清洁 General goal 总体目标 To remove debries and froeign bodies.去除碎屑与异物 Necrotic tissue坏死组织 Dead cells死亡细胞 Fibrin纤维蛋白 Toxins，MMP毒素，MMP Foreign bodies (for instance remains for previously used dressings) 异物（例如先前使用的敷料） Wound cleaning--Techniques伤口清洁-----技术 Requirements on wound rinsing solutions 对伤口冲洗液的要求 Should be sterilie 无菌 Not colored 无色 Gentel to cells/non toxic 细胞温和型/无毒 Body temperature(cooling down wound bed reduces or inactivates cell activity) 28℃ no function 体温（冷却创面、减少细胞活性或使其灭活）28℃ 无效 Wound cleaning 伤口清洁 Ways 方法 Basic cleanning of wound bed,wound edges and surrounding area 对伤口创面、边缘以及周围进行基本清洗 Antibacteira cleanning 抗菌剂清洗 Wound rinsing伤口冲洗 Wound cleaning Wet to dry 干燥清洗伤口 Debridement 清创术 Negtive pressure负压 Wound cleaning 伤口清洁----技术 Cleanig with Rinsing solution 采用冲洗溶液进行清洗 Saline 生理盐水 Ringer solution林格氏液 Indication:Cleaning wound 适应症：清洁伤口 Non touch technique非接触技术 Wound cleaning 伤口清洁----技术 Cleanning with antiseptic solution 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:Infected and contaminated wound 适应症：感染伤口和污染伤口 Non touch technique:From outside to center of wound in order to avoid further spreading of bacteria to the surrounding area. 非接触技术：从外围向中间清洗以避免细菌向周围进一步播散 Wound cleaning --Antiseptic solution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 not colored,not inacticated by body fluids无色、不会被体液灭活 do not initiate resistance ,skin irritation and allergies不会引起抗药性、皮肤刺激或过敏 Disadvantages缺点 not available and reimbursed in many countries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 Both should not be applied on cartilage and in contact with internal organs(abdominal cavity)二者均不能在软骨上运用，且不能与内部器官接触（腹腔） Wound cl