慢性伤口处理

woundcleaning--Techniques伤口清洁(qīngjié)---技术Componentswhichneedtoberemovedfromwoundbed需要从创面去除的部分Surplusexudate多余渗出物Necrotictissue坏死组织(zǔzhī)Deadcells死亡细胞Breadinggroundforbacteriaandcomponentswhichmightbesupportivetothedevelopmentofbiofilms.细菌滋养环境以及可能会促进生物被膜形成的成分第一页，共九十五页。整理课件woundcleaning伤口(shāngkǒu)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(xiānqián)使用的敷料）第二页，共九十五页。整理课件Woundcleaning--Techniques

伤口清洁(qīngjié)-----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(tǐwēn)（冷却创面、减少细胞活性或使其灭活）>28℃无效第三页，共九十五页。整理课件Woundcleaning伤口(shāngkǒu)清洁

Ways方法Basiccleanningofwoundbed,woundedgesandsurroundingarea对伤口创面、边缘(biānyuán)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

第四页，共九十五页。整理课件Woundcleaning伤口清洁(qīngjié)

----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(qīngjié)伤口Nontouchtechnique非接触技术第五页，共九十五页。整理课件Woundcleaning伤口(shāngkǒu)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(zhōngjiān)清洗以避免细菌向周围进一步播散第六页，共九十五页。整理课件Woundcleaning--Antisepticsolution

伤口清洁--消毒(xiāodú)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(guòmǐn)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）第七页，共九十五页。整理课件Woundcleaning--Antisepticsolution

伤口(shāngkǒu)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(ruǎngāo)、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第八页，共九十五页。整理课件Wounddebridement清创术Incaseofachronic,difficulttohealwoundcleaningcanbesupportedwithdifferentwaysofdebridement在慢性、难愈合性伤口的清洁中可才采用(cǎiyòng)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尽早第九页，共九十五页。整理课件Debridementopportunity清创时机(shíjī)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(xiǎoshí)以内，头面、手部伤口12小时(xiǎoshí)以内Theidealtime:8hoursafterthewound,andthehead,handwithin12hoursafterthewound第十页，共九十五页。整理课件Debridementmethods伤口(shāngkǒu)清创方法机械清创（伤口(shāngkǒu)清洗和伤口(shāngkǒu)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第十一页，共九十五页。整理课件Wounddebridemen清创术Mechanical机械性清创Wipe(mechancialyclean)thewoundwithsterilegauze无菌纱布擦拭伤口(shāngkǒu)（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。第十二页，共九十五页。整理课件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(huòzhě)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第十三页，共九十五页。整理课件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(tǐwēn)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)第十四页，共九十五页。整理课件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(quēdiǎn)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。第十五页，共九十五页。整理课件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(cāozuò)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第十六页，共九十五页。整理课件TheevolutionandapplicationofdressingsGauze

OilYam、stickingHydrocolloiddressingsAntibacterialdressings干纱布油砂、敷贴水胶体抗菌敷料(fūliào)、生物活性敷料(fūliào)第十七页，共九十五页。整理课件Wounddressings-General

伤口(shāngkǒu)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(yǔnxǔ)空气交换Comfortable舒适Economical/requireinfrequentchanges经济/不需要经常更换第十八页，共九十五页。整理课件Wounddressings-Requirements

伤口(shāngkǒu)敷料—要求Keyfunctions主要作用Keepwoundbedmoist保持(bǎochí)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第十九页，共九十五页。整理课件Wounddressings-Requirements

伤口(shāngkǒu)敷料—要求Keyfunctions主要作用Keepwoundbedmoist保持创面湿润Keepwoundsurroundingskindry保持伤口(shāngkǒu)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第二十页，共九十五页。整理课件Wounddressings-DifferentkindsCriteriaforselection选择(xuǎnzé)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疼痛第二十一页，共九十五页。整理课件Wounddressings-Requirements

伤口(shāngkǒu)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(jījiàn)、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第二十二页，共九十五页。整理课件Wounddressings-Wettherapy(TenderWet)

伤口(shāngkǒu)敷料—湿润疗法（德湿威TenderWet）Description说明(shuōmíng)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。第二十三页，共九十五页。整理课件Wounddressings-Wettherapy(TenderWet)

伤口敷料(fūliào)—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(xīshōu)伤口渗出液第二十四页，共九十五页。整理课件Wounddressings-Wettherapy(TenderWet)

伤口敷料(fūliào)—湿润疗法（德湿威TenderWet）Predominateuseinfollowingphasesofwoundhealing主要应用(yìngyòng)于伤口愈合的以下阶段Cleaning清洁(qīngjié)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保持并维持清洁第二十五页，共九十五页。整理课件Wounddressings-Wettherapy(TenderWet)

伤口敷料(fūliào)—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(yùhé)停止的伤口第二十六页，共九十五页。整理课件Wounddressings-Wettherapy(TenderWet)

伤口(shāngkǒu)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(zhùyì)Contactofdressingwithwoundbedmustbesecured敷料和创面必须牢固接触第二十七页，共九十五页。整理课件Wounddressings-Wettherapy(TenderWet)

伤口敷料(fūliào)—湿润疗法（德湿威TenderWet）Handing操作Protectwoundsurroundingarea保护伤口周围(zhōuwéi)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第二十八页，共九十五页。整理课件Wounddressings-Wettherapy(TenderWet)

伤口敷料—湿润(shīrùn)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(jiāodài)进行固定。第二十九页，共九十五页。整理课件Wounddressings—Alginates

伤口(shāngkǒu)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(jiēchù)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第三十页，共九十五页。整理课件Wounddressings—Alginates

伤口(shāngkǒu)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(zhǐxuè)作用第三十一页，共九十五页。整理课件Wounddressings—Alginates

伤口(shāngkǒu)敷料—藻酸盐类敷料Predominateuseinfollowingphasesofwoundhealing主要(zhǔyào)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很少第三十二页，共九十五页。整理课件Wounddressings—Alginates

伤口(shāngkǒu)敷料—藻酸盐类敷料Mainindication主要适应症Infectedwounds(deepandsuperficial)感染(gǎnrǎn)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第三十三页，共九十五页。整理课件Wounddressings—Alginates

伤口(shāngkǒu)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(fūliào)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第三十四页，共九十五页。整理课件Wounddressings—Alginates

伤口(shāngkǒu)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(shāngkǒu)：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第三十五页，共九十五页。整理课件Wounddressings—Hydrofiberdressings

伤口(shāngkǒu)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(xìngnéng)较高Turnsintotransparentgetwhenincontactwithwoundexudate垂直吸收创面渗出液第三十六页，共九十五页。整理课件Wounddressings—Hydrofiberdressings

伤口(shāngkǒu)敷料—亲水性材料Keyobjectives使用主要目的Absorptionofwoundexudate吸收伤口渗出液Inclusionofwoundexudateevenunderpressure(compressiontherapy)即使可以(kěyǐ)在压力作用下（加压治疗）也可以(kěyǐ)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：很少第三十七页，共九十五页。整理课件Wounddressings—Hydrofiberdressings

伤口敷料(fūliào)—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(jìnzì)伤口的危险）第三十八页，共九十五页。整理课件Wounddressings—Hydrofiberdressings

伤口敷料(fūliào)—亲水性材料Contraindication禁忌症Drywounds干燥伤口(shāngkǒu)Drynecrosiswounds干性坏死Third-orforth-degreeburns3度或4度烧伤Exercisecaution注意None第三十九页，共九十五页。整理课件Wounddressings—Hydrofiberdressings

伤口(shāngkǒu)敷料—亲水性材料Handling操作(cāozuò)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英寸第四十页，共九十五页。整理课件Wounddressings—Hydrofiberdressings

伤口(shāngkǒu)敷料—亲水性材料Fixation固定(gùdìng)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第四十一页，共九十五页。整理课件Wounddressings—Polyurethane/Foamdressings

伤口敷料(fūliào)—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(yìngyòng)，也可以单独使用第四十二页，共九十五页。整理课件Wounddressings—Polyurethane/Foamdressings

伤口敷料(fūliào)—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(zhānxìnɡ)边缘）Granulation肉芽形成Epithellialisation上皮形成thinfoamdressingonly只采用薄层泡沫敷料第四十三页，共九十五页。整理课件Wounddressings—Polyurethane/Foamdressings

伤口(shāngkǒu)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Incombinationwithcompressiontherapy联合加压治疗(zhìliáo)Onslushy,fibrincoatedwounds胶冻状纤维蛋白覆盖性伤口第四十四页，共九十五页。整理课件Wounddressings—Polyurethane/Foamdressings

伤口敷料(fūliào)—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.OnlyasacoverincombinationwithforinstanceHydrogelwound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(zhùyì)Possibilityofmacerationwhendressingcapacityisexhausted当敷料吸收能力达极限时具有浸渍的可能第四十五页，共九十五页。整理课件Wounddressings—Polyurethane/Foamdressings

伤口敷料(fūliào)—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(chóngdié)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）第四十六页，共九十五页。整理课件Wounddressings—Polyurethane/Foamdressings

伤口敷料(fūliào)—聚氨酯/泡沫敷料Fixation固定Oftennotneededduetoadhesivebordersofdressingpads由于敷料垫具有粘性边缘通常(tōngcháng)不需要固定Fixationwithsemipermeablefilms,siliconecoatedfilmsorelasticbandages以半透膜、硅涂层薄膜或弹力绷带固定第四十七页，共九十五页。整理课件Wounddressings—Hydrocolloiddressings

伤口敷料(fūliào)—水胶体敷料Description说明(shuōmíng)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第四十八页，共九十五页。整理课件Wounddressings—Hydrocolloiddressings

伤口敷料(fūliào)—水胶体敷料Keyobjectivesforapplication使用的主要目的Supportgranulation有助于肉芽组织(zǔzhī)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第四十九页，共九十五页。整理课件Wounddressings—Hydrocolloiddressings

伤口敷料(fūliào)—水胶体敷料Predominateuseinfollowingphasesofwoundhealing主要应用于伤口愈合的以下阶段Cleansing清洁(qīngjié)Granulation肉芽形成Epithelialisation上皮形成第五十页，共九十五页。整理课件Wounddressings—Hydrocolloiddressings

伤口(shāngkǒu)敷料—水胶体敷料Mainindication主要适应症Lowtomediumamountofwoundexudate少量到中等量的伤口(shāngkǒu)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第五十一页，共九十五页。整理课件Wounddressings—Hydrocolloiddressings

伤口敷料(fūliào)—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(jìnzì)可能Hypergranulation肉芽组织过度形成Diabeticfootulcers糖尿病性足部溃疡第五十二页，共九十五页。整理课件Wounddressings—Hydrocolloiddressings

伤口敷料(fūliào)—水胶体敷料Handing操作(cāozuò)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第五十三页，共九十五页。整理课件Wounddressings—Hydrocolloiddressings

伤口敷料(fūliào)—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(zhùrù)胶带之类的产品进行固定第五十四页，共九十五页。整理课件Wounddressings—Hydrogelamorphousgels

伤口(shāngkǒu)敷料—无定形水凝胶敷料Contraindication禁忌症Woundpain伤口疼痛Macerationofsurroundingskin周围皮肤(pífū)浸渍Exercisecaution注意Sensitivityagainstcomponentspossible可能会有成分过敏第五十五页，共九十五页。整理课件Wounddressings—Hydrogelamorphousgels

伤口(shāngkǒu)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(fāshēng)浸渍RinsingofwoundwithRingersolutionorsalinetoremoveresidues采用林格氏液或生理盐水冲洗去除残余凝胶第五十六页，共九十五页。整理课件Wounddressings—Hydrogelamorphousgels

伤口(shāngkǒu)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(duìyú)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第五十七页，共九十五页。整理课件Wounddressings—Hydrogelsheets

伤口(shāngkǒu)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(téngtòng)Smallamountofexudatecanbeabsorbed可以吸收少量渗出液Contain15-95%waterbutarenotabsolutelyinwater含15-95%水分但不溶于水Cushioningeffect缓冲作用第五十八页，共九十五页。整理课件Wounddressings—Hydrogelsheets

伤口(shāngkǒu)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(xìbāo)生长Supportofautolyticdebridement有助于自溶性清创Coolingeffectonburns对于烧伤具有冷却作用Painreduction减轻疼痛第五十九页，共九十五页。整理课件Wounddressings—Hydrogelsheets

伤口(shāngkǒu)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(ròuyá)形成保护

Epithelialisationpreventsdessication上皮形成防止干燥第六十页，共九十五页。整理课件Wounddressings—Hydrogelsheets

伤口(shāngkǒu)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(pífū)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皮肤供体位置第六十一页，共九十五页。整理课件Wounddressings—Hydrogelsheets

伤口(shāngkǒu)敷料—水凝胶片Contraindication禁忌症Escharduetoarterialulceration因动脉性可以(kěyǐ)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Sensitivitytocomponentspossible可能对成分过敏第六十二页，共九十五页。整理课件Wounddressings—Hydrogelsheets

伤口(shāngkǒu)敷料—水凝胶片Handing操作(cāozuò)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）第六十三页，共九十五页。整理课件Wounddressings—Hydrogelsheets

伤口(shāngkǒu)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(fǒuzé)采用纱布或非编织型胶带固定第六十四页，共九十五页。整理课件Wounddressings—silvercontainingwounddressings

伤口(shāngkǒu)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(yǒuxiào)对抗多种细菌第六十五页，共九十五页。整理课件Wounddressings—silvercontainingwounddressings

伤口(shāngkǒu)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(ɡuǎnɡpǔ)对抗微生物（金黄色葡萄球菌、假单胞菌、MRSA等）第六十六页，共九十五页。整理课件Wounddressings—silvercontainingwounddressings

伤口(shāngkǒu)敷料—含银伤口敷料Predominateuseinthefollowingphaseofwoundhealing主要应用于伤口愈合(yùhé)的以下阶段Cleaningoninfectedwounds清洁用于感染性伤口第六十七页，共九十五页。整理课件Wounddressings—silvercontainingwounddressings

伤口(shāngkǒu)敷料—含银伤口敷料Mainindication主要适应症Secondaryhealingwoundslikepressureorlegulcer中等愈合伤口如压迫性溃疡或腿部溃疡Tumorwounds,abscess,etc.肿瘤伤口、脓肿等Cleaningwoundswhichareinfected,indangerofinfectionorbadlysmelling对感染伤口或有感染危险或严重(yánzhòng)异味性伤口进行伤口清洁第六十八页，共九十五页。整理课件Wounddressings—silvercontainingwounddressings

伤口(shāngkǒu)敷料—含银伤口敷料Contraindication禁忌症Barefibers,bonesormuscles纤维、谷歌、或肌肉裸露(luǒlù)Exercisecaution注意Sensitivityagainstcomponents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第六十九页，共九十五页。整理课件Handing(Dependingontypeofdressing)操作（根据敷料类型(lèixíng)）Dressingshouldbeaboutaninchbiggerthanwound敷料应当高于伤口约1英寸Padsshouldbeeasilyplacedinwound,directedcontactwithwoundbed垫料应当容易放入伤口，直接与创面接触IncaseofdryandsuperficialwoundsdressingshouldbementionedwithRingersolutionorSalineofcombinedwithhydogel在干燥且表浅的伤口情况下，应当采用林格氏液或生理盐水结合水凝胶对其进行湿润Dressingcanbecuttooptimalsize可将敷料剪裁至最佳尺寸Dailydressingchangeoninfectedwounds每日更换感染性伤口的敷料Wounddressings—silvercontainingwounddressings

伤口(shāngkǒu)敷料—含银伤口敷料第七十页，共九十五页。整理课件Fixation固定Dependsoninformationofproductioncompanies按照产品公司所提供的信息(xìnxī)进行固定Wounddressings—silvercontainingwounddressings

伤口(shāngkǒu)敷料—含银伤口敷第七十一页，共九十五页。整理课件注意：Note需控制银离子的释放速度(sùdù)，保证安全性Toensuresafety,andweshouldcontrolthereleasespeedofsilverions某些银离子使用不当会着色Someimproperuseofsilveriondressingcanshading价格相对较高Thepriceisrelativelyhigh

第七十二页，共九十五页。整理课件Wounddressings—Nonwoven(aborbent)padswithsuperabsorber

伤口(shāngkǒu)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(xìjūn)和坏死物Moistwoundclimateiskept保持湿润的伤口环境Smellisbound限制伤口异味第七十三页，共九十五页。整理课件Wounddressings—Nonwoven(aborbent)padswithsuperabsorber

伤口(shāngkǒu)敷料—具有强力吸收剂的无纺布（吸收垫料）Keyobjectivesforapplication使用的主要目的Keepingthewoundmoist保持伤口湿润Absorptionofwoundexudate吸收伤口渗液Enclosureofbacteria,celldebris,etc.包裹细菌细胞碎片等Predominateuseinfollowingphasesofwoundhealing主要应用于伤口愈合的以下阶段(jiēduàn)Cleansing清洁

whenwoundproduceshighamountofexudate伤口产生大量渗出物时第七十四页，共九十五页。整理课件Wounddressings—Nonwoven(aborbent)padswithsuperabsorber

伤口(shāngkǒu)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(shāngkǒu)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）第七十五页，共九十五页。整理课件Wounddressings—Nonwoven(aborbent)padswithsuperabsorber

伤口敷料—具有强力(qiánɡlì)吸收剂的无纺布（吸收垫料）Handing操作Productsmustnotbecut不能对产品进行裁剪Productsshouldnotbefoldedtogether产品不应叠放在一起Canstayonwoundforseveraldays(dependsonamountofexudate)可以在伤口上保留数日Fixation固定Fixationdependsonwoundlocationandskincondition依据伤口位置(wèizhi)和皮肤状况进行固定第七十六页，共九十五页。整理课件Wounddressings—Nonwoven(aborbent)padswithsuperabsorber

伤口敷料(fūliào)

—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(jùyǒu)严重异味的伤口第七十七页，共九十五页。整理课件Wounddressings—Activecoaldressings

伤口(shāngkǒu)敷料—活性碳敷料Handing操作(cāozuò)Dressingshouldbeaboutaninchbiggerthanwound敷料应当大于伤口1英寸Padsshouldbeeasilyplacedinwound垫料应当容易放入伤口内Dressingsmustnotbecut不能对敷料进行剪裁第七十八页，共九十五页。整理课件Wounddressings—Activecoaldressings

伤口(shāngkǒu)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(shāngkǒu)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Atraumaticdressingchang