齐鲁医学慢性伤口处理

woundcleaning--Techniques伤口清洁---技术Componentswhichneedtoberemovedfromwoundbed需要从创面去除的部分Surplusexudate多余渗出物Necrotictissue坏死组织Deadcells死亡细胞Breadinggroundforbacteriaandponentswhichmightbesupportivetothedevelopmentofbiofilms.细菌滋养环境以及可能会促进生物被膜形成的成分慢性伤口处理共94页，您现在浏览的是第1页!woundcleaning伤口清洁Generalgoal总体目标Toremovedebriesandfroeignbodies.去除碎屑与异物Necrotictissue坏死组织Deadcells死亡细胞Fibrin纤维蛋白Toxins，MMP毒素，MMPForeignbodies(forinstanceremainsforpreviouslyuseddressings)异物（例如先前使用的敷料）慢性伤口处理共94页，您现在浏览的是第2页!Woundcleaning--Techniques

伤口清洁-----技术Requirementsonwoundrinsingsolutions对伤口冲洗液的要求Shouldbesterilie无菌Notcolored无色Genteltocells/nontoxic细胞温和型/无毒Bodytemperature(coolingdownwoundbedreducesorinactivatescellactivity)>28℃nofunction体温（冷却创面、减少细胞活性或使其灭活）>28℃无效慢性伤口处理共94页，您现在浏览的是第3页!Woundcleaning伤口清洁

----技术CleanigwithRinsingsolution采用冲洗溶液进行清洗Saline生理盐水Ringersolution林格氏液Indication:Cleaningwound适应症：清洁伤口Nontouchtechnique非接触技术慢性伤口处理共94页，您现在浏览的是第4页!Woundcleaning--Antisepticsolution

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notcolored,notinacticatedbybodyfluids无色、不会被体液灭活donotinitiateresistance,skinirritationandallergies不会引起抗药性、皮肤刺激或过敏Disadvantages缺点notavailableandreimbursedinmanycountries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Bothshouldnotbeappliedoncartilageandincontactwithinternalorgans(abdominalcavity)二者均不能在软骨上运用，且不能与内部器官接触（腹腔）慢性伤口处理共94页，您现在浏览的是第5页!Wounddebridement清创术Incaseofachronic,difficulttohealwoundcleaningcanbesupportedwithdifferentwaysofdebridement在慢性、难愈合性伤口的清洁中可才采用不同的清创术进行支持治疗Requirements要求：Asgentleaspossible尽可能温柔Asthoroughaspossible尽可能彻底Assoonaspossible尽早慢性伤口处理共94页，您现在浏览的是第6页!Debridementmethods伤口清创方法机械清创（伤口清洗和伤口浴，水下低频超声波处理、聚氨酸脂类软性泡沫复合物产品等）Mechanicaldebridement外科清创（剪刀、手术刀、锋利勺、刮器）Surgicaldebridement酶清创（蛋白质、肽类）Enzymaticdebridement生物清创Biosurgicaldebridement自溶性清创（内活性伤口敷料、如水胶体、水凝胶）Autolyticdebridement慢性伤口处理共94页，您现在浏览的是第7页!Wounddebridemen清创术Surgical手术清创Removalofdebriswithcurette,abrasororscapel采用刮匙、刮除器或手术刀去除碎屑Usuallyperformedbysurgeonorspeciallytrainednursesundersupervisionofsurgeon.通常由外科医生执行清创或者在外科医生的监督下由护士进行清创。Cave空洞Mightbepainfulforpatient可能会引起患者疼痛Chanceofbleeding可能会出血InseverecasesintmustbeconductedinOR严重时必须采用手术进行处理慢性伤口处理共94页，您现在浏览的是第8页!Wounddebridemen清创术Biosurgicalwithmaggots采用蛆进行生物手术Serratiamarcecens沙雷杆菌Advantage优点Veryselectivecleaning/Antisepticeffect选择性清洁/防腐作用Stimulategranulation刺激肉芽生长Almostpainfree几乎无痛Disadvantage缺点Notalwayseasytoapplyandkeepinplace不容易使用而且不容易固定。Ethicalaspectsneedconsideration.需要对伦理学方面加以考虑。慢性伤口处理共94页，您现在浏览的是第9页!TheevolutionandapplicationofdressingsGauze

OilYam、stickingHydrocolloiddressingsAntibacterialdressings干纱布油砂、敷贴水胶体抗菌敷料、生物活性敷料慢性伤口处理共94页，您现在浏览的是第10页!Wounddressings-Requirements

伤口敷料—要求Keyfunctions主要作用Keepwoundbedmoist保持创面湿润Keepwoundsurroundingskindry保持伤口周围皮肤干燥Avoidcoolingdownofwoundtemperature避免伤口温度降低Protectfrominfection预防感染Shouldnotleaveresidualsinwound伤口内不应留下残余物慢性伤口处理共94页，您现在浏览的是第11页!Wounddressings-DifferentkindsCriteriaforselection选择标准Woundsite伤口位置Exudate渗出物Signsofinfection感染迹象Conditionofwoundsurroundingskin伤口周围皮肤状况Pain疼痛慢性伤口处理共94页，您现在浏览的是第12页!Wounddressings-Wettherapy(TenderWet)

伤口敷料—湿润疗法（德湿威TenderWet）Description说明Hydroactivedressingpadforwettherapy采用水活化性敷料垫用于湿润疗法Madeofhighlyabsorbingpolyacrylate采用高吸水性聚丙烯酸酯制造Activeabsorbingandrinsingeffect具有有效吸收和冲洗作用AlreadyactivatedversionplusseparateRingersolutionavailable可以采用已活化型或者未活化型外加林格氏液。慢性伤口处理共94页，您现在浏览的是第13页!Wounddressings-Wettherapy(TenderWet)

伤口敷料—湿润疗法（德湿威TenderWet）Predominateuseinfollowingphasesofwoundhealing主要应用于伤口愈合的以下阶段Cleaning清洁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机制ReduceMMP减少MMPProtectsandmaintainsclean保持并维持清洁慢性伤口处理共94页，您现在浏览的是第14页!Wounddressings-Wettherapy(TenderWet)

伤口敷料—湿润疗法（德湿威TenderWet）Contraindication禁忌症Escharduetountreatedarterialulceration由未经治疗的动脉性溃疡所导致的焦痂Exercisecaution注意Contactofdressingwithwoundbedmustbesecured敷料和创面必须牢固接触慢性伤口处理共94页，您现在浏览的是第15页!Wounddressings-Wettherapy(TenderWet)

伤口敷料—湿润疗法（德湿威TenderWet）Fixation固定Fixationwithnonabsorbentdressing,bandageornonwovenadhesive以非吸收性敷料、绷带或非编织型胶带进行固定。慢性伤口处理共94页，您现在浏览的是第16页!Wounddressings—Alginates

伤口敷料—藻酸盐类敷料Keyobjectivesforapplication使用的主要目的Woundfilling填充伤口Supportofautolyticdebridementduetogetinformation凝胶形成有助于自溶性清创Absorptionofwoundexudate吸收伤口渗出液Embedbacteriaandtoxininstructure将细菌和毒物包裹在凝胶中Haemostaticeffect具有止血作用慢性伤口处理共94页，您现在浏览的是第17页!Wounddressings—Alginates

伤口敷料—藻酸盐类敷料Mainindication主要适应症Infectedwounds(deepandsuperficial)感染伤口（深部和表浅）Necroticwounds(deepandsuperficial)坏死伤口（深部和表浅）Woundswithstagnatinghealing愈合停止的伤口Woundswiithtendencyforbleeding存在出血倾向的伤口慢性伤口处理共94页，您现在浏览的是第18页!Wounddressings—Alginates

伤口敷料—藻酸盐类敷料Fixation固定Alginatesneedtobecoveredbyasecondarydressing藻酸盐类敷料需要采用次级敷料加以覆盖Non-infectedwoundFineporedfoamdressing:hydrocolloidorfilmdressing非感染性伤口：细孔泡沫敷料、水胶敷料或薄膜敷料InfectedwoundElasticgauzebandages:tubularbandagesornonwovenfixationproducts感染性伤口：弹力绷带、筒形绷带或非编织性固定产品慢性伤口处理共94页，您现在浏览的是第19页!Wounddressings—Hydrofiberdressings

伤口敷料—亲水性材料Keyobjectives使用主要目的Absorptionofwoundexudate吸收伤口渗出液Inclusionofwoundexudateevenunderpressure(pressiontherapy)即使可以在压力作用下（加压治疗）也可以吸入伤口渗液Predominateuseinfollowingphasesofwoundhealing主要应用于伤口愈合的以下阶段Cleansing:Exudingsloughedwounds清洁：排除伤口腐肉Granulation:肉芽形成：很少慢性伤口处理共94页，您现在浏览的是第20页!Wounddressings—Hydrofiberdressings

伤口敷料—亲水性材料Contraindication禁忌症Drywounds干燥伤口Drynecrosiswounds干性坏死Third-orforth-degreeburns3度或4度烧伤Exercisecaution注意None慢性伤口处理共94页，您现在浏览的是第21页!Wounddressings—Hydrofiberdressings

伤口敷料—亲水性材料Fixation固定Hydrofiberdressingsneedtobecoveredbyassecondarydressing富含纤维敷料需要采用次级敷料加以覆盖Absorbingpads、gauzebandagesornonwovenfixationproducts吸收垫、纱布绷带或非编织性产品慢性伤口处理共94页，您现在浏览的是第22页!Wounddressings—Polyurethane/Foamdressings

伤口敷料—聚氨酯/泡沫敷料Predominateuseinfollowingphasesofwoundhealing主要应用于伤口愈合的以下阶段Cleaning清洁evenincaseofsloughy/necroticwounds，sometimesoninfectedwounds(withooutadhesiveborder)甚至可以用于坏死性伤口,有时可以用于感染性伤口（无粘性边缘）Granulation肉芽形成Epithellialisation上皮形成thinfoamdressingonly只采用薄层泡沫敷料慢性伤口处理共94页，您现在浏览的是第23页!Wounddressings—Polyurethane/Foamdressings

伤口敷料—聚氨酯/泡沫敷料Contraindication禁忌症Infectedwounds(borderedversions)感染伤口（边界模糊）Drywound干燥伤口Third-orforth-degreeandhigher3度或3度以上烧伤Necroticwounds.OnlyasacoverinbinationwithforinstanceHydrogelwound坏死伤口，只能与其他敷料合用坐覆盖，如水凝胶敷料。Exercisecaution注意Possibilityofmacerationwhendressingcapacityisexhausted当敷料吸收能力达极限时具有浸渍的可能慢性伤口处理共94页，您现在浏览的是第24页!Wounddressings—Polyurethane/Foamdressings

伤口敷料—聚氨酯/泡沫敷料Fixation固定Oftennotneededduetoadhesivebordersofdressingpads由于敷料垫具有粘性边缘通常不需要固定Fixationwithsemipermeablefilms,siliconecoatedfilmsorelasticbandages以半透膜、硅涂层薄膜或弹力绷带固定慢性伤口处理共94页，您现在浏览的是第25页!Wounddressings—Hydrocolloiddressings

伤口敷料—水胶体敷料Keyobjectivesforapplication使用的主要目的Supportgranulation有助于肉芽组织形成Absorptionofcelldebris吸收细胞碎屑Limitedabsorptionofwoundexudate伤口渗出液吸收有限Ensuringamoistwoundenvironment确保湿润的伤口环境Protectionagainstexternaleffects保护伤口防止外部影响慢性伤口处理共94页，您现在浏览的是第26页!Wounddressings—Hydrocolloiddressings

伤口敷料—水胶体敷料Mainindication主要适应症Lowtomediumamountofwoundexudate少量到中等量的伤口渗出液Abrasions,first-andsseconddegreeburns,decubitus,legulcers擦伤、1度或2度烧伤、褥疮、腿部溃疡WoundsinEpithelialisationphase处于上皮形成时期的伤口Asacoverforotherwounddressings(e.g.alginates)作为其他伤口敷料的覆盖物慢性伤口处理共94页，您现在浏览的是第27页!Wounddressings—Hydrocolloiddressings

伤口敷料—水胶体敷料Handing操作Someofhydrocolloiddressingshouldhavebodytemperaturewhenapplied在使用时应将某些水胶体敷料加热至体温Surroundingofwoundneedstobefreeofhair伤口周围备皮Dressingneedtobeapproximatelyaninchbiggerthanwound敷料应当大于伤口约1英寸Canstayonwoundupto7days可以在伤口上保留长达7天Dressingchangerequiredwhengetclosetoborderofdressing当凝胶接近敷料边缘时则需要更换敷料慢性伤口处理共94页，您现在浏览的是第28页!Wounddressings—Hydrogelamorphousgels

伤口敷料—无定形水凝胶敷料Contraindication禁忌症Woundpain伤口疼痛Macerationofsurroundingskin周围皮肤浸渍Exercisecaution注意Sensitivityagainstponentspossible可能会有成分过敏慢性伤口处理共94页，您现在浏览的是第29页!Wounddressings—Hydrogelamorphousgels

伤口敷料—无定形水凝胶敷料Fixation固定Secondarydressingabsolutelynecessary绝对有必要使用次级敷料固定Hydropolymerorhydrocolloiddressingsincaseofnon-infected,moistwounds对于非感染伤口,可以采用水聚合型敷料或水胶体型敷料加以固定Semipermeablefilmsfordrywounds对于干性伤口，可以采用半透膜固定Sterilepadsornonwovenadhesivesforinfectedwounds对于感染性伤口，可以采用无菌敷料或非编织型胶带固定慢性伤口处理共94页，您现在浏览的是第30页!Wounddressings—Hydrogelsheets

伤口敷料—水凝胶片Keyobjectivesforapplication使用的主要目的Superficial,drywoundsarekeptmoist保持浅表、干燥伤口的湿润Accelerationofcellgrowth促进细胞生长Supportofautolyticdebridement有助于自溶性清创Coolingeffectonburns对于烧伤具有冷却作用Painreduction减轻疼痛慢性伤口处理共94页，您现在浏览的是第31页!Wounddressings—Hydrogelsheets

伤口敷料—水凝胶片Mainindication主要适应症Useonpaper/cortisone/olderskin联合可的松涂在纸面上用于老年人的皮肤Superficial,cleanabrasion浅表的清洁擦伤Burnsuptosecond-degree直至2度的烧伤Woundsproducinglittleexudate伤口几乎没有渗出物Skindonorsites皮肤供体位置慢性伤口处理共94页，您现在浏览的是第32页!Wounddressings—Hydrogelsheets

伤口敷料—水凝胶片Handing操作Dressingshouldbeapproximatelyaninchbiggerthanwound敷料应当大于伤口约1英寸Dressingscanbecuttoidealsize可以将敷料剪至适当大小Canstayupto7daysonwound(whendressingturnsuncleardressingchangerequired)可以在伤口保留7天以上（当敷料变得不透明时，则需要更换敷料）慢性伤口处理共94页，您现在浏览的是第33页!Wounddressings—silvercontainingwounddressings

伤口敷料—含银伤口敷料Description说明Wounddressingcoatedwithsilver（e.g.woundcontactllayer,foam.alginate,hydrofiber）伤口敷料涂银（例如,伤口接触层、泡沫敷料、藻酸盐敷料、水性纤维敷料）Useofbactericidalimpactofsilver利用银离子杀菌Releaseofsilverionswhenincontactwithwoundexudate与伤口渗出液接触时可以释放银离子Silveriseffectiveagainstawiderangeofbacteria银可以有效对抗多种细菌慢性伤口处理共94页，您现在浏览的是第34页!Wounddressings—silvercontainingwounddressings

伤口敷料—含银伤口敷料Predominateuseinthefollowingphaseofwoundhealing主要应用于伤口愈合的以下阶段Cleaningoninfectedwounds清洁用于感染性伤口慢性伤口处理共94页，您现在浏览的是第35页!Wounddressings—silvercontainingwounddressings

伤口敷料—含银伤口敷料Contraindication禁忌症Barefibers,bonesormuscles纤维、谷歌、或肌肉裸露Exercisecaution注意Sensitivityagainstponents对成分过敏Silvershouldonlybeusedaslongasindicated只要有过敏表现不能直接使用Releaseofsilverionsnotsufficientondrywounds在干性伤口上银离子不能充分释放慢性伤口处理共94页，您现在浏览的是第36页!Fixation固定Dependsoninformationofproductionpanies按照产品公司所提供的信息进行固定Wounddressings—silvercontainingwounddressings

伤口敷料—含银伤口敷慢性伤口处理共94页，您现在浏览的是第37页!Wounddressings—Nonwoven(aborbent)padswithsuperabsorber

伤口敷料—具有强力吸收剂的无纺布（吸收垫料）Description说明Nonwovenpadcontaining/surroundingsuperabsorber无纺布垫料，含有强力吸收剂Canabsorbhighamountofliquids可以吸收大量液体Bacteriaandcelldebriscanbeabsorbed可以吸收细菌和坏死物Moistwoundclimateiskept保持湿润的伤口环境Smellisbound限制伤口异味慢性伤口处理共94页，您现在浏览的是第38页!Wounddressings—Nonwoven(aborbent)padswithsuperabsorber

伤口敷料—具有强力吸收剂的无纺布（吸收垫料）Mainindication主要适应症Onwoundsthatproducehighamountofexudate(pressure,legulcer,etc.)伤口产生大量渗出液（压迫性溃疡、腿部溃疡等）Contraindication禁忌症Ondrywoundsriskthatpadstickstothewound(canharmnewganulatedtissue)干性伤口具有垫料粘附伤口的风险（可损害新生肉芽组织）慢性伤口处理共94页，您现在浏览的是第39页!Wounddressings—Nonwoven(aborbent)padswithsuperabsorber

伤口敷料—具有强力吸收剂的无纺布（吸收垫料）Description说明Widelyvarietyavailable应用广泛Madeofseverallayers由数层构成Cancontainadditionalmaterialslikeanabsorptionpad可以包含附加材料，如吸收垫料Bindssmell限制异味Whenindirectedcontactwithwounditbindsproteinmoleculesandbacteria在直接接触伤口时可以与蛋白质分子以及细菌相结合Predominateuseinfollowingphasesofwoundhealing主要应用于伤口愈合的以下阶段Cleansing:oninfected,badlysmellingwounds清洁：用于感染伤口、具有严重异味的伤口慢性伤口处理共94页，您现在浏览的是第40页!Wounddressings—Activecoaldressings

伤口敷料—活性碳敷料Description说明Semipermeable,polyurethanefilm半透明、聚氨酯甲酸酯薄膜Woundprotection,fixationmaterial伤口保护型固定材料Barriertobacteria阻挡细菌Enablesmonitoringofwound能都进行伤口监护Naabsorptioncapacity无吸收能力Atraumaticdressingchange非创伤性换药Predominateuseinfollowingphasesofwoundhealing主要应用于伤口愈合的以下阶段Epithelialisation:asprimarywounddressing上皮形成阶段：作为主要的伤口敷料Fixationofotherdressinginallphasesofwoundhealing在伤口愈合阶段固定其他敷料慢性伤口处理共94页，您现在浏览的是第41页!Wounddressings—Transparentfilmdressings

伤口敷料—透明薄膜敷料Handing操作Materialcanbeoptimalsize材料可被剪裁成最佳尺寸Atraumaticdressingchangethrough非创伤性换药Overstretchingoffilm薄膜过度拉伸Fixation固定Noadditionalfixationrequired不需要额外固定Usedasfixationforotherwounddressings作为其他敷料的固定物使用慢性伤口处理共94页，您现在浏览的是第42页!Wounddressings—Hyaluronanwoundtreatment

伤口敷料—透明质酸型伤口护理材料Mainindication主要适应症Acutewoundsproducinghighamountofexudate产生大量渗出液的急性伤口Deep,underminedwounds潜行的深部伤口Skindonorsites皮肤供体部位Chronic,difficulthealingwounds慢性难愈合性伤口Contraindication禁忌症Clinicinfectedwounds临床感染性伤口Drynecrosis干性坏死Combinationwithantiseptics与消毒剂联合使用Sensitivitytoponents对成分过敏慢性伤口处理共94页，您现在浏览的是第43页!Wounddressings—Hydrocapillarydressings

伤口敷料—毛细管吸水型敷料Description说明Woundpadonthebasisofcellulosewithsuperabsorber(polyacrylate)伤口垫采用纤维素和超强吸水剂（聚丙烯酸酯）为基础Highabsorptioncapacity吸收能力高Supportofgranulation有助于肉芽形成Protectionagainstexternaleffects保护伤口防止外部影响Availablewithandwithoutadhesiveborders可采用有或无粘性边缘的敷料Predominateuseinfollowingphasesofwoundhealing主要应用于伤口愈合的以下阶段Cleanign清洁Ganulation肉芽形成慢性伤口处理共94页，您现在浏览的是第44页!Wounddressings—Hydrocapillarydressings

伤口敷料—毛细管吸水型敷料Handing操作Surroundingskinmustbefreeofhair周围皮肤必须没有毛发Dressingshouldbeaboutaninchbiggerthanwound敷料应当大于伤口约1英寸Useadditionalprimarymaterialondeepwounds,woundswithalotfibrinormoistnecroticwounds深部伤口、含纤维蛋白伤口或湿性坏死伤口额外使用初级材料Canstayupto7daysonwound在伤口上保留长达7天Fixation固定Nocoverrequired不需要覆盖物Additionalfixationpossiblewithsemipermeablefilmornonwovenadhesive可以采用半透膜或非编织型胶带进行额外固定慢性伤口处理共94页，您现在浏览的是第45页!Wounddressings—collagenwounddressings

伤口敷料—胶原型伤口敷料Mainindication主要适应症Chronicandsecondaryhealing,noninfectedwounds慢性及二级愈合伤口Stagnatingwounds停滞伤口Controindication禁忌症Necroticwounds坏死性伤口Infectedwounds感染性伤口慢性伤口处理共94页，您现在浏览的是第46页!Wounddressings—

Opencelllformdressings

伤口敷料—开孔式泡沫敷料Description说明Polyurethaneorpolyvinylalcoholfoam聚氨酯甲苯酸或聚乙烯醇泡沫Opencellsurface开孔表面Usedforwoundconditioning需要对粉剂进行湿化Adhesivetightlytothewound与伤口紧密粘合Mechanicaldebridementatdressingchange(painful)更换敷料时需要进行机械清创（疼痛）Woundscleaningofinfected,secondaryhealingwounds需要对感染性次级愈合伤口进行清洁Limitedabsorptionofexudateandcelldebris吸收渗出物和细胞碎屑能力有限Goodoxygenandwatervapourpermeability氧气和水蒸气渗透性良好Predominantuseinfollowingphasesofwoundhealing主要用于伤口愈合的以下阶段Granulation肉芽形成慢性伤口处理共94页，您现在浏览的是第47页!Wounddressings—

Opencelllformdressings

伤口敷料—开孔式泡沫敷料Handing操作Cuttooptimalfit剪裁成最佳的适用尺寸Placeflatonwound平放在伤口上Dressingchangeafter12to48hours(dependsonamountofexudate)12到48小时后更换敷料Fixation固定Nonwovenfixationmaterialorelasticbandage无纺布材料或弹性材料Lightpressioncanbereachedthroughadditionalpadsbetweenfoamandfixatin通过敷料和固定物之间的额外垫料可以实现压迫慢性伤口处理共94页，您现在浏览的是第48页!Woundcleaning伤口清洁

Ways方法Basiccleanningofwoundbed,woundedgesandsurroundingarea对伤口创面、边缘以及周围进行基本清洗Antibacteiracleanning抗菌剂清洗Woundrinsing伤口冲洗WoundcleaningWettodry干燥清洗伤口Debridement清创术Negtivepressure负压

慢性伤口处理共94页，您现在浏览的是第49页!Woundcleaning伤口清洁

----技术Cleanningwithantisepticsolution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:Infectedandcontaminatedwound适应症：感染伤口和污染伤口Nontouchtechnique:Fromoutsidetocenterofwoundinordertoavoidfurtherspreadingofbacteriatothesurroundingarea.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慢性伤口处理共94页，您现在浏览的是第50页!Woundcleaning--Antisepticsolution

伤口清洁--消毒溶液IodineAdvantages优点EffevtiveagainstGrampostiveandGramnegtivebacteria可有效对抗革兰阳氏和阴性菌Availableindifferentformsforapplication(ointment,lotions)可以采用不同形式加以运用（软膏、洗液）Disadvantages缺点Colored(makeswoundassessmentdifficult)有色（难以对伤口进行评估）Inactivatedbybodyfluids会被体液灭活Sensitivitymightoccur可能会发生过敏Systemicsideeffectsduetoabsortion吸收会导致全身副作用慢性伤口处理共94页，您现在浏览的是第51页!Debridementopportunity清创时机病情许可，越早越好Illnesspermission,thesooner,thebetter无明显感染表现，均可清创Noapparentinfection,debridementperformance已有感染，但伤口有异物或较多坏死组织，也可清创，清创后伤口暂不缝合IftheWoundisinfected,buthaveaforeignbodyormuchnecrotictissue,wecanalsodebridement,anddonotwoundclosureafterdebridement急性伤口理想时间：伤后8小时以内，头面、手部伤口12小时以内Theidealtime:8hoursafterthewound,andthehead,handwithin12hoursafterthewound慢性伤口处理共94页，您现在浏览的是第52页!Wounddebridemen清创术Mechanical机械性清创Wipe(mechancialyclean)thewoundwithsterilegauze无菌纱布擦拭伤口（机械型清洗）Gauzecanbemoistordry可以采用湿性或干性纱布Cave:mightbepainfulforpatient孔洞：可能造成患者疼痛Aternative选择Soakedgauzeisappliedtowoundandshouldberemovedgently.Everytimesomeofwounddebriswillremainingauze.对伤口使用浸湿纱布，而且去除纱布时动作应当轻柔。每次都会有一些伤口碎屑留在纱布内。慢性伤口处理共94页，您现在浏览的是第53页!Wounddebridemen清创术Enzymatic酶解清创术Removalofdebriswithemzymes采用酶法Havetoberenewedfrequently必须经常更新Needamoistandbodywarmenvironmenttobeeffective需要保肢潮湿和体温环境才能产生作用Havetobeappliedattheareaofdebris必须在清创区域使用CollegesSanty1Z**Ointment(胶原酶Santy1)Enzymaticdebridingagent(清创酶)慢性伤口处理共94页，您现在浏览的是第54页!Wounddebridement清创术Autolytic自熔性清创术Facilitatebodyownsofmechanismofdebridementmoistdressing采用适当的湿性敷料促进机体自身清创机制Advantage优点Cellfriendly细胞亲和性Almostpainfree几乎无痛Easytodo容易操作Disadvantage缺点Tasksmoretimethanforinstancesurgicaldebridement比手术清创方法花费更多时间Needstobeadaptedtotheindividualrequirementsofwound需要适合伤口的个体要求Notalwayseffectiveforinstanceincaseofthicknecroticlayer在诸如坏死层较厚的情况下慢性伤口处理共94页，您现在浏览的是第55页!Wounddressings-General

伤口敷料—总体Requirements要求Maintainmoistenvironment保持环境湿润Sterile无菌Removeexcessexudate去除多余渗出物Nontoxic无毒性Nonsenstizing无过敏性Protectthewoundfromfurthertrauma保护伤口防止进一步损伤Allownontraumaticremoval去除时不会产生损伤Protectfrommigrationofbacteria保护伤口防止细菌迁移Keepwoundatbodytemperature(Isulation)保护伤口处于体温下（绝缘）Allowgaseousexchange允许空气交换Comfortable舒适Economical/requireinfrequentchanges经济/不需要经常更换慢性伤口处理共94页，您现在浏览的是第56页!Wounddressings-Requirements

伤口敷料—要求Keyfunctions主要作用Keepwoundbedmoist保持创面湿润Keepwoundsurroundingskindry保持伤口周围皮肤干燥Avoidcoolingdownofwoundtemperature避免伤口温度降低Protectfrominfection预防感染Shouldnotleaveresidualsinwound伤口内不应留下残余物慢性伤口处理共94页，您现在浏览的是第57页!Wounddressings-Requirements

伤口敷料—要求Occlusiveornonocclusivedressings封闭型或非封闭型敷料Occlusiveenvironmentissupportiveforwoundhealing封闭环境有助于伤口愈合Attention注意Incaseofinfection,severecontaminationexposedtendon,bone,fistualsanocclusioncanbedangerous.在肌腱、骨骼暴露以及瘘管存在感染或严重感染时，封闭可能具有危险Keepwoundsurroundingskindry保持伤口周围皮肤干燥慢性伤口处理共94页，您现在浏览的是第58页!Wounddressings-Wettherapy(TenderWet)

伤口敷料—湿润疗法（德湿威TenderWetKeyobjectivesforapplication使用的主要目的Hydrationofwoundbedfor24hours使创面保湿24小时Initiationandsupportofautolyticdebridement引发或有助于自溶性清创ReleaseofRingersolutionintowoundbed将林格氏液释放至创面Absorptionofwoundexudate吸收伤口渗出液慢性伤口处理共94页，您现在浏览的是第59页!Wounddressings-Wettherapy(TenderWet)

伤口敷料—湿润疗法（德湿威TenderWet）Mainindication主要适应症Infectedwounds(deepandsuperficial)感染伤口（深部和表浅）Necroticwounds(deepandsuperficial)坏死伤口（深部和表浅）Woundswithstagnatinghealing愈合停止的伤口慢性伤口处理共94页，您现在浏览的是第60页!Wounddressings-Wettherapy(TenderWet)

伤口敷料—湿润疗法（德湿威TenderWet）Handing操作Protectwoundsurroundingarea保护伤口周围区域Mustbechangedafter24hours24小时后必须更换GreenstripesofTenderWet24arefacingawayfromwoundbed在创面使用德湿威24时，应将绿色条纹面朝外。Dressingmustnotbecut不要对敷料进行裁减慢性伤口处理共94页，您现在浏览的是第61页!Wounddressings—Alginates

伤口敷料—藻酸盐类敷料Alginatefromoriginatefrombetweenalgae海藻纤维源于褐藻Alginateturnintogetwhenincontactwithwoundexudate藻酸盐类敷料与伤口接触时可变成凝胶Alginatescanabsorbasignificantamountmorethantheirweightofwoundfluids藻酸盐类敷料可以吸收显著高于其自身重量的伤口渗出液慢性伤口处理共94页，您现在浏览的是第62页!Wounddressings—Alginates

伤口敷料—藻酸盐类敷料Predominateuseinfollowingphasesofwoundhealing主要应用于伤口愈合的以下阶段Cleaning清洁Granulation肉芽形成Especiallyfordeepsmallcavitywounds尤其用于较深而且较小的孔腔性溃疡Rarely很少慢性伤口处理共94页，您现在浏览的是第63页!Wounddressings—Alginates

伤口敷料—藻酸盐类敷料Contraindication禁忌症Dryorcrustedwounds干燥或结痂伤口Drynecrosis干性坏死Third-degreeburnsorhigher3度或3度以上烧伤Exercisecaution注意Pressurereleaseswoundexudateagain压力解除伤口会再次渗出RemoveAlginatesresidual-free去除藻酸盐类敷料时不应留有残余（dangerofinfection）(具有危害性或感染性)Donotapplywithpressure不应加压使用Avoidoverlappingwoundedges避免与伤口边缘重叠慢性伤口处理共94页，您现在浏览的是第64页!Wounddressings—Hydrofiberdressings

伤口敷料—亲水性材料Description说明Madeof“Natriumcarboxymethycellulose”由羧甲基纤维素制成Highabsorptioncapacity吸收性能较高Turnsintotransparentgetwhenincontactwithwoundexudate垂直吸收创面渗出液慢性伤口处理共94页，您现在浏览的是第65页!Wounddressings—Hydrofiberdressings

伤口敷料—亲水性材料Mainindication主要适应症Highlysecretingwounds高分泌型伤口Acuteandchronicwounds急性和慢性伤口Postoperativewounds术后伤口First–andsecond-degreeburns1度或2度烧伤Incaseofproblematic(indangertodevelopmaceration)surroundskin用于伤口周围皮肤存在问题的情况下（具有发展成浸渍伤口的危险）慢性伤口处理共94页，您现在浏览的是第66页!Wounddressings—Hydrofiberdressings

伤口敷料—亲水性材料Handling操作Dressingmaydevelopthewoundbyabout1inch敷料可以在伤口上重叠约1英寸厚Hydrofibertamponadesshouldbepokeoutofthewoundbyapproximatelyaninch水性纤维敷料填塞应高于伤口约1英寸慢性伤口处理共94页，您现在浏览的是第67页!Wounddressings—Polyurethane/Foamdressings

伤口敷料—聚氨酯/泡沫敷料Description说明Madeofafine(Polyurethane)foamcoveredwithasemiocclusivePolyurethanefilm由覆盖一层封闭型聚氨基甲酯薄膜的精制泡沫构成Foamdressingshavehighabsorption泡沫敷料具有高度吸水性Airpermeablemembraneenablesgasexchange空气可以渗入薄膜使气体得以交换Availablewithandwithoutadhesive可以和胶带一起应用，也可以单独使用慢性伤口处理共94页，您现在浏览的是第68页!Wounddressings—Polyurethane/Foamdressings

伤口敷料—聚氨酯/泡沫敷料Mainindication主要适应症Exudatingwounds渗出性伤口Ascavityindeep,underminedexudatingwounds孔腔较深的潜行性渗出伤口Inbinationwithpressiontherapy联合加压治疗Onslushy,fibrincoatedwounds胶冻状纤维蛋白覆盖性伤口慢性伤口处理共94页，您现在浏览的是第69页!Wounddressings—Polyurethane/Foamdressings

伤口敷料—聚氨酯/泡沫敷料Handing操作Cavityproductsfordeepwounds孔腔产品用于深部伤口Dressingshouldbeoverlapping敷料应当重叠使用Dressingscansometimesbecuttofittingsize有时可将敷料裁剪成适当大小Canstayonwoundupto7days(dependingonamountofwoundexudate)可以在伤口保留长达7天（依据伤口渗出液的量）慢性伤口处理共94页，您现在浏览的是第70页!Wounddressings—Hydrocolloiddressings

伤口敷料—水胶体敷料Description说明Semioclusive,madeofwater-repellingpolymermatrix(thinpolyurethanefilm)半封闭型采用防水性聚合物基质形成（聚氨酯薄膜）Matrixcontainshydrocolloidsubstance基质包含亲水物质Sometimeswithadhesivenonwovenboardersorflatterboardersforeasyapplication有时存在便于使用的粘性非编织性边缘或更为平整的粘性边缘慢性伤口处理共94页，您现在浏览的是第71页!Wounddressings—Hydrocolloiddressings

伤口敷料—水胶体敷料Predominateuseinfollowingphasesofwoundhealing主要应用于伤口愈合的以下阶段Cleansing清洁Granulation肉芽形成Epithelialisation上皮形成慢性伤口处理共94页，您现在浏览的是第72页!Wounddressings—Hydrocolloiddressings

伤口敷料—水胶体敷料Contraindication禁忌症Deepmycosis深部真菌病Highlyexudingorbleedingwounds高度渗血或出血伤口Third–orforth-degreeburns3度或4度烧伤Osteomyelitis骨髓炎Deepwoundswithbarebones,muscles,tendons深部伤口伴谷歌、肌肉、肌腱裸露Exercisecaution注意Macerationofsurroundingskinpossible伤口具有浸渍可能Hypergranulation肉芽组织过度形成Diabeticfootulcers糖尿病性足部溃疡慢性伤口处理共94页，您现在浏览的是第73页!Wounddressings—Hydrocolloiddressings

伤口敷料—水胶体敷料Fixation固定Nosecondarydressingorfixationneeded不需要次级敷料或固定

Hydrocolloiddressingsareoftenusedasfixationforotherwounddressings水胶体敷料通常最为其他敷料的固定物Ifneededfurtherfixationwithadhesiveproductslikefilmsect,possible如果需要，可以采取注入胶带之类的产品进行固定慢性伤口处理共94页，您现在浏览的是第74页!Wounddressings—Hydrogelamorphousgels

伤口敷料—无定形水凝胶敷料Handing操作Applicationof0.3to0.5cmofgelonwound在伤口上使用0.3到0.5cm的凝胶Protectionofsurroundingskinnecessarytoavoidmaceration有必要对周围皮肤进行保护以免发生浸渍RinsingofwoundwithRingersolutionorsalinetoremoveresidues采用林格氏液或生理盐水冲洗去除残余凝胶慢性伤口处理共94页，您现在浏览的是第75页!Wounddressings—Hydrogelsheets

伤口敷料—水凝胶片Description说明Semiolcusive,transparentdressings半封闭性、透明敷料Applicationdirectlyonwound直接用于伤口Keepwoundmoist保持伤口湿润Allowinspectionofwoundthroughdressing可以通过敷料检查伤口Canstayseveraldaysonwound可以在伤口保留数日Reducepain减轻疼痛Smallamountofexudatecanbeabsorbed可以吸收少量渗出液Contain15-95%waterbutarenotabsolutelyinwater含15-95%水分但不溶于水Cushioningeffect缓冲作用慢性伤口处理共94页，您现在浏览的是第76页!Wounddressings—Hydrogelsheets

伤口敷料—水凝胶片Predominateuseinfollowingphasesofwoundhealing主要应用于伤口愈合的以下阶段CleaningRehydrateseschar，supportautolyticmechanisms清洁再次水化焦痂、有助于自溶机制Granulationprotects肉芽形成保护

Epithelialisationpreventsdessication上皮形成防止干燥慢性伤口处理共94页，您现在浏览的是第77页!Wounddressings—Hydrogelsheets

伤口敷料—水凝胶片Contraindication禁忌症Escharduetoarterialulceration因动脉性可以所导致的焦痂Strongexudatiionorbleeding大量渗出液或出血Deepwounds,mycosis伤口较深或真菌病Sheetsshouldnotbeusedoninfectedwounds水凝胶片不用于感染性伤口

Exercisecaution注意Sensitivitytoponentspossible可能对成分过敏慢性伤口处理共94页，您现在浏览的是第78页!Wounddressings—Hydrogelsheets

伤口敷料—水凝胶片Fixation固定Productswithadhesivebordersdon’trequireadditionalfixation带有粘性边缘的产品不需要额外固定Otherwisefixationwithgauzebandageornonwovenadhesives否则采用纱布或非编织型胶带固定慢性伤口处理共94页，您现在浏览的是第79页!Wounddressings—silvercontainingwounddressings

伤口敷料—含银伤口敷料Keyobjectivesforapplication使用的主要目的Killingofbacteria杀灭细菌Wideeffectivenessagainstmicroorganisms(Saphylococcusaureus,Pseudomonas,MRSA,etc.)广谱对抗微生物（金黄色葡萄球菌、假单胞菌、MRSA等）慢性伤口处理共94页，您现在浏览的是第80页!Wounddressings—silvercontainingwounddressings

伤口敷料—含银伤口敷料Mainindication主要适应症Secon