Surgical dressing

 Dressing for the surgeon is the most common thing, but also the easiest to neglect to do. A sterile wound dressing can be due to improper infection; leaving for drinking in the skin flap necrosis; more headaches, some skin necrosis wounds, to heal after a long dressing; and exposed bone flap can often get through. dressing does have a lot of stress, just the right dressing can often miraculous. I witnessed after the internal fixation to the plate and skin necrosis in patients with bone exposure, the Chinese secret prescription medication, less than a month, miraculously healed. There is a phalanx fracture case, cross Kirschner wire after skin injury and necrosis of the rub , leading to extensor tendon exposure, recovered two weeks after Chinese dressing. It is about: martial art of dressing skills.
principles are: sterile. clean. Clear inactivation necrosis, tissue. to maintain and promote growth of granulation. to prevent the wound and cover exposed wounds exposed. promote wound healing.
As for the general use of saline rich in blood supply, the chances of infection is small, and a keen sense of the mucosa.
combination of glucose and insulin to stimulate the growth of granulation.
and hypertonic saline may have inhibited the growth of granulation
first told me of iodine volts and alcohol is more suitable range of applications. iodine is iodized, or wound on the greasy parts of the developed sebaceous glands invalid or ineffective. And alcohol or iodine to be able to skim, to better protein fixed bacteria , a place rich in sebaceous glands more penetrating power. so will be applied around the wound in the scalp. But both of these because there are some irritation. so open wound can not be applied.
The main application of saline to Notes of red and wet, as this may be a wide area of the wound or wound merger is not flat, hoping to place some impurities red note and infected material.
insulin is mainly used in non-healing wounds in diabetic patients.
The purpose of hypertonic salt is local swelling wound healed, and to achieve partial dehydration, and the role of honey as some say.
there needles and other major local release of gentamicin in the wound is already infected. < br> not to mention is that principle. just as well as with the new clean and off. may have the effect of iodine is not very confident in the reason. critical moment, or to apply tincture of iodine, alcohol.
1, Surgery dressing the first to follow aseptic principles. from the beginning of the end of reclaiming should comply with the time until the dressing.
2, when the use of alcohol, when the use of vaseline gauze, this is learned. must familiar with normal saline, alcohol, iodine, yellow gauze and Vaseline gauze mechanism of action, so that when dealing with different wounds can be the appropriate choice.
3, the choice of dressing. Some people like to use a lot of dressing, thinking This can be very good to keep sterile; there are others who only a few layers that can save costs. In fact, little choice multiple choice dressings are not appropriate. dressings how much the right choice? It said the growth was from the wound since the growth in the first few days mainly wound granulation tissue growth, it needs a more humid environment, so the first few days can be multi-layers of dressings to maintain a relatively moist wound. And a later stage, mainly the growth of the wound keratinocyte growth, wound at this time require a relatively dry environment, so the dressing to play a role in isolation should be as thin as possible under the premise. Why do some people always late but not the cuticle wound healing, I would like to have relations with the above.
to remember: The purpose of our surgical dressing is: two offers.
that:
1, for the wound to provide a relatively sterile environment, so as not to attack.
2, provide a relatively favorable for the growth of the wound, healing environment, to heal as soon as possible.
The purpose of dressing is: 1. observed the wound 2. removal of necrotic tissue 3. Clean the wound 4. unobstructed drainage 5. to promote tissue growth .
3, severe wound infection and sometimes for the simple wash the wound clean and more difficult to achieve, can be used times, The role of drainage, but the humidity is also a breeding ground for bacterial growth, bacteria will enter in 6-8 hours on the number of proliferating, so for a serious wound infection, drugs to be done frequently changes (preferably 3-4 times / day), many people like the wound wet dressing were added gentamicin, the first 1-2 result is very good, long-term results are poor, and easily lead to resistant bacteria produce.
Vaseline gauze to provide wet environment conducive to wound granulation, and can reduce the leakage of tissue fluid, early wound can stop bleeding, but for a serious wound infection should be used with caution, because of its poor drainage and easy, often add to the infection.
hypertonic dehydration of glucose as a drug, can enhance the role of plasma osmolality resulting from dehydration, nutrition for poor local wound infection, wound area, with poor efficacy of other drugs, after dressing or invalid, the surface of the skin ulcer or erosion varicose veins, wound healing difficult by the shallow depth Ⅱ Ⅱ degrees to a small degree burn edema, wound healing slowly and those with pressure ulcers is more efficacious. hypertonic glucose can be evenly distributed in the wound, resulting in hypertonic environment, dehydration caused by bacterial cells, bacteria unable to reproduce ability, cell death and cell dehydration can make the body part to reduce the wound and granulation tissue edema, and to form a protective film to prevent the cells continue to invasive infection, can improve local blood circulation, improve nutrition around the wound and promote wound healing; In addition, Glucose also has a myogenic effect, can reduce wound pain, and help wound healing.
purulent wound treatment. the general if the wound or purulent pus out of reach of a sense of volatility, timely and open drainage is necessary, do not hold fluke psychology, looking forward to it absorbs, the drainage is the best way, open wound shall be sought after in the necrotic tissue completely clear that if one can not at all clear, you can gradually removed after the dressing change. and then fill in the diluted PVP tournament -I gauze, adequate drainage should not be filled too tight race adversely affect the blood supply and drainage. of course, can also use saline gauze. or topical antibiotics such as penicillin, and big celebration.
we are a closed wound with alcohol and powerful disinfectant iodine
open wound with normal saline and hypertonic saline powerful disinfectant iodine
severe edema in the wound when used with multi-
glucose and insulin slower growth in the wound of malnutrition for use
protection principle 1 sterile 2 drugs 3 promotes growth
wound dressing when you can scrape the surface of the appropriate due to edema or granulation fresh, and then chymotrypsin wet packing, so that local organizations can promote healing of infected wounds or
fat liquefaction after wound drainage should be promptly interrupted stitches, using iodine and alcohol around the wound disinfection, the hand will be as much as possible out of the wound pus, and with a 20ml syringe gentamicin (light) or vancomycin (severe) remove the blunt needle tied directly to rinse and drain port directly Withdrawing fluid. to hold gauze drainage strip, usually two or three times the infection can be removed, sealed.
rich in fat, fat liquefaction prone areas Our experience is wide open incision (fat liquefaction of all open areas), culture + sensitivity, strengthening the dressing. If that is infected with culture-positive myself.
we all know that the incision want to change a long time, we In order to shorten the time to reduce the financial burden of patients, we sterilized after the initial subcutaneous injection of gentamicin ,@@@@local place to cut daily glucose powder@@@@. dressing until the wound infiltration After a little gauze to stimulate granulation. fresh butterfly after the two suture or glue together to Brad. We did the control, significantly shortened the time.
talk about the lower extremity vasculitis after amputation, the incision did not heal in the for- medicines that that experience:
general such as skin blood flow in patients with poorly, although the pain, necrosis of the limb was amputated, but after amputation of the incision is still very difficult to heal, and often associated with infection and easy! < br> This incision dressing is very important to closely observe the first incision when dressing, and if suppuration, suppurative Department must immediately cut the suture, removal of necrotic tissue, cut open, unobstructed drainage, generally put a small drainage strip can!
addition, festering wound dressing, do not hold anything against the stench, the incision must be carefully wiped the pus moss, and not because of the pain and dare not touch incision, pus, after removing moss have a slightly bloodshot leaking, so it helps to cut the early healing!
open wound dressing is best not to let alcohol into the wound, the wound healing of alcohol on negative (this is my PhD on behalf of my internship teaching point of view)
other iodine 2 3 is the classic wine disinfection methods in orthopedics, orthopedic arrived when the new patient to us for leadership requires that we must strictly abide by the debridement.
polluting oil on the wound, our use turpentine wash away the stain
the old granulation wounds: regeneration of such poor granulation tissue (dark red color, not fresh, rugged, and sometimes bleeding was old appearance), the surrounding tissues difficult to heal, to the surface of granulation curette tissue curettage, or cut off, so that bleeding, exposing fresh granulation, and topical rubber high (this is the traditional Chinese medicine is said to rot myogenic, Western medicine will be washed with hydrogen peroxide to achieve the purpose to rot)
if pus, should be observed whether the abscess cavity or sinus, pay attention to changes in body temperature.
for Pseudomonas aeruginosa infection in the wound:
characterized as a light green pus, there is a special kind of sweet stench, if the wound scab, scab under empyema, necrotic tissue, to remove crusts, pus and necrotic tissue. aeruginosa infection in burn wounds early skin grafting can be tangential. can also be 1% to 2% phenoxyethanol wet dressing, or 0.1% of celebration Trappe Su, 1% silver sulfadiazine, 10% of a sulfur solution, such as wet compress Miloon. wounds, such as less available 3% acetic acid, 10% chloral hydrate solution, such as wet compress.
1. Alcohol: bedsore protection (50% a), skin and equipment sterilization (70%)
2. hydrogen peroxide (3%): cleaning wounds, ulcers, pus sinus, release of necrotic tissue, removal of adhesive dressings.
3. Qingda neomycin solution (0.2-0.5%): local irrigation, for Pseudomonas aeruginosa, Staphylococcus aureus wound infection.
4. saline (0.9%): wound cleaning wet compress.
5. nitrofurazone (0.02% ) solution: ulcers, purulent wounds and other surface disinfection.
6. Zinc oxide gelatin: prolonged unhealed leg ulcers.
7. mercurochrome (2%): skin and mucous membrane disinfection, the country still in use.
8. Cod Liver Oil: local coating, used to promote wound epithelialization.
9. acetic acid (0.5-2%): burns, burns, infected wounds.
10. chlorhexidine (0.05% ): wound, wash the wound.
11. magnesium sulfate (50%) solution: for contusion, cellulitis, erysipelas, and other anti-inflammatory swelling. Local moist heat.
12. boric acid ointment (5%) : burns, abrasions, skin ulcers and bedsores.
13. Band-Aid: affixed to the small wound.
for osteomyelitis with bone exposed to ground when the first dressing change, because a lot of leakage can be QD, and dressing To many, the dressing process, should be kept clear of necrotic tissue (very important!), marrow can be placed within the (oil) gauze. my experience is to wash the wound with saline, and then 0.1% povidone-iodine rinse, and then rinse with hydrogen peroxide, and finally celebrate a large gauze wet dressing, dressing. granulation when fresh, less leakage when the surgical removal of sequestrum, sclerotic bone, muscle flap coverage with appropriate wounds, external fixation and external fixation, to be flap, the bone lengthening again. However, sometimes several times before surgery for therapeutic purposes.
for refractory sinus surgery such as brain, heart bypass surgery or chronic osteomyelitis caused by sinus, usually Early use of or the September eighty-two Dan Dan + red ointment, to mention rot to pus, the latter with a red ointment Shengjisan + shut works well, even resistant P. aeruginosa or S. aureus infection can be very good cured.
replantation or vascularized flap surgery can be used with the temperature close to the best solution Furacillin dressing, dressing will happen with alcohol scolded a; ring finger dressing gauze dressing should be avoided, local best filled with broken gauze.
on the gauze with a. played for abscess drainage after the role, while the abscess has just cut to stop bleeding .2 It can be placed directly on the role of the wound in order to facilitate the growth of granulation .3 wound its replacement cycle as the case may be, such as wound exudate more should be replaced daily, less exudate depending on the circumstances given the fixed package .4 graft area should be 5 --- 7 days to replace the first time, after the visual cries .5 non-stick gauze and the wound is not strong to protect the growth of skin grafts are not torn off.
Summary:
dressing: deferred handling open wounds, incision and drainage of soft tissue infections, surgical incision infection, due to local pathological reactions, so that the wounds appeared exudate, suppuration, necrosis or tissue defect, etc., should be properly addressed. This process includes checking the wound, pus and necrotic tissue removal, drain placement or removal of dressing change and dressing, etc. This process is called dressing, also known as dressing or replacement of the drug.
purposes: 1. Observation of the wound; 2. removal of necrotic tissue; 3. Clean the wound; 4. unobstructed drainage; 5. promoting tissue growth;
principles: 1. aseptic principles; 2. inactivation removal of necrotic tissue; 3. to maintain and promote growth of granulation; 4. promote wound healing;
dressing of the basic techniques: 1. set free strain concept; 2. to lift dressing methods; 3. dressing goods delivery methods; 4. wound and surrounding skin disinfection method; 5. wrap fixation methods; 6. dirt dressing treatment;
one dressing preparation
1. full understanding of the wound, the size of the depth of the wound site, the number of gauze wound cavity filling, drain, and whether with or without removal or replacement, the need for debridement and irrigation, the need for stitches or suture. dressing of the required medicines and other equipment to check if available, the special items should be fully prepared, such as configuration wound topcoat solution with antibiotics, local anesthetics required debridement blade, deep wounds of the probe with the long vascular clamp, replacement Special suprapubic cystostomy drainage pipe. mental state of patients, systemic conditions and dressing process may happen, should be fully prepared to learn more about.
2. sterile preparations: General requirements dressing in the morning room care or dressing room half an hour after cleansing, preferably in the dressing room dressing. wearing a mask hat, the patients go to dressing room, observation wounds (wound opened along the direction of gauze to expose, easy to make the wound opened again the vertical split) to assess the need for equipment,bailey UGG boots, and the number of dressings, types, and then to wash their hands, ready dressing items. generally requires two sterile bent plate, two pairs of tweezers, alcohol, cotton balls and so on, clip his weapons, the forceps must be upside down, can not tilt to the order of the first clip clip forceps, curved plate placed among the top folder covered in gauze, iodine, alcohol, plate bending points on both sides, the first clip of iodine wine folder after the alcohol cotton ball cotton ball (if the first folder of alcohol, the alcohol remaining folder forceps cotton ball on the diluted tincture of iodine tincture of iodine, affecting disinfection effect).
3. Operation: hand to take foreign materials, and then take the tweezers layer, if the cotton ball wet with salt water after the stick opened. two pairs of tweezers, a contact with the skin, a contact with materials (two still do not touch). disinfection of the wound and suture lightly along the dip, and then (clean the wound) from the inside out, back to the font consumption, alcohol more than twice the range to more than cover the gauze. cover gauze smooth down, cover more than eight-gauze (usually a piece of gauze four). viscose fabric to be smooth striae perpendicular to the direction of gauze and adhesive, generally three, both sides of the blank stick, the middle one. Finally, wash your hands (to protect themselves).
4. order: first, after a clean pollution, after briefly complicated. One more wound is also true of patients .
Second, the frequency
dressing materials soaked in principle that should be dressing
1. General wounds: in the first 24h, after every 2-3 days / times; 2. special wound: breast surgery After the 3-5 days / times; 3. :7-9 days after skin grafting / times; 4. digestive tract fistula :2-3 days / times; 5. summer, a day for, apply alcohol yarn;
Third, select the number of suitable dressing? wounds a few days at the beginning of the growth is mainly the growth of granulation tissue, it needs a more humid environment, so the first few days can be multi-layers of dressings to maintain a relatively moist wound. And a later stage, the growth of skin wounds is mainly the growth of the wound at this time require a relatively dry environment, so the dressing to play a role in isolation should be as thin as possible under the premise. dressings protect the wound from outside contamination in addition to the role, but also has a certain drainage effect, so dressing and wound dressing should be closely attached to ensure, especially in the wound when compared with the surrounding low-lying.
four commonly used dressings select
1. Alcohol: bedsore protection (50%), skin and equipment sterilization (70%). epidermal integrity of the wound dressing can be with alcohol, alcohol can not be used if the skin damage, and generally use iodine. The classic method of disinfection is 2% iodine alcohol, two times three times iodothyronine disinfection.
2, iodine: The mucous membrane irritation, without de-iodine with ethanol, no corrosion, and low toxicity. iodophor both application (mucous membranes, skin, etc.), or sterilization was better than iodine (less allergic), but also the scope of application, bleeding wounds, the effect is not good, the wound is too large can not be applied. Some hospitals have eliminated iodine, because the allergic reactions and more, you need to de-iodine, there is corrosion.
application of povidone iodine and alcohol is more suitable range. iodophor is a complex of iodine, or wound on the greasy parts of the developed sebaceous glands invalid or ineffective. the alcohol or iodine to be able to skim, to better fixed bacterial protein, rich in sebaceous glands where more penetrating power. so it applied to the scalp wound around.
3. normal saline (0.9%): wound cleaning wet compress. is generally used in blood supply , wound secretions are more chances of infection is small, and a keen sense of the mucous membranes. The main application of saline injection to red and wet, because for a wide range of wound area or wound merger is not flat, red note to place some of impurities and infected material.
4. hypertonic saline: When used in wound edema heavier. hypertonic salt purpose is healed wound swelling, and to achieve partial dehydration. hypertonic saline plus Vaseline gauze may stimulate granulation growth, often used in clinical no one closed the wound, or infection of the wound after debridement and thorough application.
5. hypertonic glucose: a kind of dehydrated drug, can enhance the role of plasma osmolality resulting from dehydration, The poor nutrition of local wound infection, wound area, the effects after use of other drugs difference between dressing or invalid, the surface of the skin ulcer or erosion varicose veins, wound healing difficulties are shallow degrees to deep Ⅱ Ⅱ small burn edema, slow wound healing were, and more efficacious bedsores. hypertonic glucose can be evenly distributed in the wound, resulting in hyperosmotic environment induced dehydration of bacterial cells, bacteria lose their reproductive capacity, cell death, and local cellular dehydration can make the body, reducing the wound and granulation tissue, edema, and to form a protective film to prevent the cells continue to invasive infection, can improve local blood circulation, improve nutrition around the wound and promote wound healing; In addition, glucose also has the myogenic effect, can reduce wound pain, and help wound healing. < br> 6. hydrogen peroxide (3%): cleaning wounds, ulcers, pus sinus, release of necrotic tissue, removal of adhesive dressings.
7. gentamicin solution (0.2-0.5%): local irrigation, for Pseudomonas aeruginosa, Staphylococcus aureus wound infection.
8. nitrofurazone (0.02%) solution: ulcers, purulent wounds and other surface disinfection.
9. Zinc oxide gelatin: prolonged unhealed leg ulcers.
10. Insulin is mainly used in non-healing wounds in diabetic patients.
11. mercurochrome (2%): disinfection of skin and mucous membranes, skin grazed mercurochrome best, after ten minutes to dry and painted without dressing < br> 12. Cod Liver Oil: partial coating, used to promote wound epithelialization.
13. acetate (0.5-2%): burns, burns, infected wounds.
14. chlorhexidine (0.05%) : wound, wash the wound.
15. rivanol: the best wound contraction (direct wet cover).
16. magnesium sulfate (50%) solution: for contusion, cellulitis, erysipelas, etc. anti-inflammatory swelling. Local moist heat.
17. boric acid ointment (5%): burns, abrasions, skin ulcers and bedsores. covered with a boric acid solution to rot until the wet granulation fresh. Shengjisan powder can be used to promote growth of granulation .
18. conducive to the wound surface moist tissue growth, this is what we usually like to cover the wound with saline gauze main reason, while there are clear physiological saline gauze, the role of drainage, but moist environment is the growth of bacteria breeding ground for bacteria in the number of 6-8 hours will be entered on the proliferation of, so for a serious wound infection, drugs to be done frequently changes (preferably 3-4 times / day), many people like to celebrate the wounds were added Trappe Su wet packing, the first 1-2 result is very good, long-term results are poor, and could easily lead to resistant bacteria produce.
19. vaseline gauze to provide moist wound environment conducive to growth of granulation, and can reduce tissue fluid leakage, early wound can stop bleeding, but for the serious wound infection should be used with caution, because of its poor drainage and easy, often add to the infection.
five common wound treatment
1. Clean the wound with iodophor disinfection, stimulate the small, the effect is good; for clean, new granulation wounds, but also cover the addition of vaseline gauze dressing change patients to alleviate the pain and reduce tissue fluid leakage, loss.
2. blood supply abundant opportunities for small wounds can be infected with normal saline wet look simple, sterile dressing materials can be.
3. For a skin defect wounds, defects repeatedly washed with salt water, surrounded by available conventional iodophor disinfection, disinfection, saline gauze or vaseline gauze, saline gauze help keep the wound fresh, dry, Vaseline gauze is conducive to wound granulation.
4. infected or contaminated wounds draining pus principle is necessary, split open sutures, expansion of the wound thoroughly drainage, the wound repeatedly washed with hydrogen peroxide and saline, necrotic tissue should be given to debridement, antibiotics, gauze packing can also be used within the wound, wound around three times better off with alcohol, iodine tincture of iodine twice disinfection. Of course, the infection of the wound dressing to be changed every day.
addition, festering wound dressing, do not hold anything against the stench, the incision must be carefully wiped the pus moss, and not because of pain in patients not touch incision, pus moss should be removed after the slight bloodshot leaking, so it helps to cut the early healing!
5. bedsores, suppurative osteomyelitis and other infected wounds: iodine disinfectant wound around the wound to hydrogen peroxide, normal saline, gentamicin dressing.
6. osteomyelitis with bone exposed to the dressing when the first ground, because a lot of leakage, and the dressing to be more. in the dressing process, should be ready removal of necrotic tissue, marrow can be placed within the gauze. thumb is to wash the wound with salt water, then rinse of 0.1% povidone-iodine, hydrogen peroxide and then rinse, and finally celebrate big wet packing gauze, dressings coverage. granulation when fresh, less leakage when the surgical removal of sequestrum, sclerotic bone, muscle flap coverage with appropriate wounds, external fixation and external fixation until the flap, re bone lengthening.
7. fracture line outside the Patients followed a fixed dressing is the first iodophor disinfection (and cleaning to remove necrotic tissue), followed by disinfection using hydrogen peroxide and then normal saline wash, and finally cover the wound nitrofurazone stuff. wait for the granulation, the line of free flap coverage.
8. incision fat liquefaction: a place rich in the fat prone to fat liquefaction, this time wide open incision (fat liquefaction of all open areas), culture + sensitivity, strengthening the dressing. incision want to change such a long time, In order to shorten the time after the initial disinfection of local subcutaneous gentamicin, glucose powder to place the incision daily dressing changes, wound exudate to be less stimulating growth of granulation after the gauze, sutures or butterfly fresh tape after the two Lahti.
9. long unhealed ulcer wound dressing to use traditional Chinese medicine. Traditional dressing has its own unique, but usually there is no sterile concept. For example: for refractory sinus (such as the brain After surgery, coronary bypass surgery or chronic osteomyelitis caused by sinus, usually with early or the September eighty-two Dan Dan + red ointment, to mention rot to pus, the latter with a red ointment Shengjisan + shut, very good even the Pseudomonas aeruginosa or resistant S. aureus infection can be a good cure.
10. wound on polluting oil, we wash away that stain with turpentine.
11. For the old granulation wounds: The species poor granulation tissue regeneration (dark red color, not fresh, rugged, and sometimes bleeding was old appearance), difficult to heal the surrounding tissue to the surface of granulation tissue curette to scrape or cut off, so that bleeding, exposing fresh granulation, external application of adhesive plaster (this is the traditional Chinese medicine is said to rot myogenic, Western medicine will be washed with hydrogen peroxide to achieve the purpose to rot). If pus, should be to observe whether the abscess or sinus, pay attention to changes in body temperature.
12. For the Pseudomonas aeruginosa wound infection: pus is characterized by light green, with a special sweet stench, if the wound scab, scab under the empyema, necrotic tissue, to remove crusts, pus and necrotic organization. early burn wound excision aeruginosa infection can cut skin. can also be 1% to 2% phenoxyethanol wet dressing, or with 0.1% gentamicin, 1% silver sulfadiazine, 10% of a sulfur solution, such as wet Miloon deposited. wound as small available 3% acetic acid, 10% solution of chloral hydrate and other wet compress.
VI Notes
1. sterile wound dressing is generally a 24-hour, 72-hour general observation of the local swelling of the seepage situation.
2. open wound after dressing for 24,48,72 hours a day, paying particular attention prone to hematoma or drainage and remove any dangerous situation more critical.
3. orthopedic wound more wound infection is a common skin necrosis, decubitus wounds, generally in a certain period of hypertonic saline, re-used in the infection, leaking more of the wound, can quickly reduce the wound and granulation tissue edema, reducing leakage.
4. replantation surgery or vascularized flap surgery can be used with the temperature close to the best solution Furacillin dressing, gauze dressing to avoid the ring finger bandage, gauze filled with broken local is best.
5. For large wounds, First, note that debridement, necrotic tissue has been included for the tendon and the vascular tissue necrosis do not condone, for dressing in a few, the boundaries are determined once the clear cut. reluctantly left, it will only delay the growth of granulation, or even cause an infection. < br> 6. For most of the necrotic tissue had been removed the wound, to take proper care of the growth of granulation, granulation tissue itself has the ability to fight infection, and if there is no obvious oozing, not to use antibiotics or other medicine dressing, with only iodine margin of skin disinfection, can be covered with wet saline gauze.
7. Do not put gauze on the wound, it should be on the saline gauze to prevent excessive salt evaporation.
8. Note the wound infection Bacterial culture + sensitivity do a re-dressing in order to avoid future passive.
dressing commonly used drugs
1. saltwater
have to promote granulation tissue nutrition and the role of the adsorption plane surface discharge of granulation tissue without negative stimulus. isotonic saline cotton and gauze used to clean wounds, wound wet dressing, filling abscess; isotonic saline solution used to wash wound cavity; 3% to 10% of the salt has a strong dehydration, edema for granulation the wound.
2.3% hydrogen peroxide in contact and organizational
decomposition in oxygen, has a bactericidal effect. for flushing trauma wounds, wounds *** or odor, especially for anaerobic infection of the wound. < br> 3.0.02% potassium permanganate solution
slow decomposition of the release of oxygen, but the lasting effect, with cleaning, deodorizing, antiseptic and bactericidal effect. for washing rotting stench, infected wounds, especially for suspected tired Oxygen infection, anus and perineal wounds. 1:5000 solution often used clinically to wet compress.
4.0.1% Leifonuer , 0.02% nitrofurazone solution has antibacterial
and sterilization. for cleaning infected wounds and wet compress.
5. You-Suo (bleaching powder, boric acid) solution
with sterilization, antiseptic odor, dissolved necrotic tissue. for pus and dead rot organizations and more malodorous wound cleaning and wet compress. The preparation should be sealed from light, not long home, placed for not more than a week. large area of the wound should not be applied in order to avoid excessive absorption of chloride ions.
6. polyethylene topiramate iodine (PVP-I)
for new fungicides, bacteria, fungi, spores were .0.05% to 0.15% effective solution for the mucous membrane, wound, abscess irrigation; 1% solution of sterile incision used for mulching ; 1% to 2% solution for the wet packing wound infection, most suitable for chronic lower extremity ulcers and cancer ulcer.
7.
solution commonly used antibiotic neomycin solution of 0.5%, 0.16% gentamicin , 0.5% chlortetracycline, bacitracin 2%, 2% to 5% solution of kasugamycin, etc., used to wait two suture the wound contamination, the larger wounds (such as burn) wound wet dressing before skin grafting, dressings should be every 1 day change. chloramphenicol pills directly into infected wounds, each lcm21 tablets, day 1.
8.1% ~ 2% Phenoxy ethanol
has a bactericidal effect against P. aeruginosa, the effect is most well, the use of continuous wound wet dressing.
9.0.01% ~ 0.05% and 0.02% benzalkonium bromide solution
chlorhexidine field in the wound cleaning, wound irrigation latter than the former.
10.10% garlic solution
bactericidal phagocytic cells and enhance the role of Staphylococcus aureus infection better.
11.2% ~ 4% methyl violet (gentian violet) solution
bactericidal and astringent. for superficial disinfection of skin or mucous membrane ulcers, and to promote healing knot crazy.
12.
pure carbolic acid solution, corrosive, bactericidal effect. burning with pure carbolic acid solution, anal fissure and chronic sinus swabs so unhealthy granulation tissue necrosis in order to promote healing. alcohol swab after use required to neutralize it, and then isotonic saline swab.
13.10% ~ 20% silver nitrate solution
for burning anal fissure, chronic sinus and excessive growth of granulation tissue corrosion, after the required use of isotonic saline swab.
14.
oil gauze with drainage, protection of wounds, dressing difficult time drying and to extend the role of dressing. wound secretions were less can be replaced every 2 to 3 days. commonly used are: ① Vaseline gauze; ② cod liver oil gauze: a nutrition and promotion of granulation and epithelial growth, etc., used in slow healing wounds.
15. powders, ointments class
(1) iodoform gauze: has antibacterial, antiseptic, astringent, to smell, and promote granulation growth. for a chronic sinus gland secretion, such as fistula, wound cleared tuberculosis. iodoform toxicity , not long-term use;
(2) 10% ~ 20% ichthyol ointment: the role of anti-inflammatory swelling back for early abscess;
(3) 10% zinc oxide ointment: Apply to the skin surface, there to protect the skin from the secretions of erosion, commonly used in intestinal fistula, biliary fistula skin around;
(4) streptomycin ointment: Apply topical gauze, wound for tuberculosis;
(5) 2 % polyethylene topiramate iodine ointment: for the treatment of burns, chronic ulcers, results were satisfactory;
(6) more than a help ointment: for the infected wound.
16.
traditional Chinese medicines such as red ointment , Shengjisan, Shengji Yuhong cream, purple burn ointment, MEBO, Daqing ointment with pain, Sida myogenic, pus to rot and so on.
iodine, alcohol can only be used ...