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摘要:慢性伤口因为护理难度非常大,持续时间比较长,患者的要求较高,欠缺统一护理标准,护理人员对于伤口的处理方式不被病人所理解,包含伤口清创、预后判断、选取敷料等具有比较大的护理风险以及无法避免的护理风险。文献资料显示,对于伤口评估以及操作流程加以规范,采取准确方式判断伤口预后效果和存在的问题,强化专科护理质量,减少安全隐患,充分体现零缺陷管理目标,属于临床对慢性伤口开展护理的基本原则。下肢静脉溃疡属于复杂性伤口,一直以来为临床外科治疗以及护理广泛关注的问题,该文对于下肢静脉溃疡伤口的护理进展情况做一综述。
关键词:下肢静脉溃疡;伤口;护理进展
Abstract: The prevalence of venous leg ulcers (VLUs) differs between 1.5% and 3% in the genera population. The challenge in treating VLUs is common recurrence. Moreover, VLUs can be resistant to healing, despite appropriate treatment. In these cases, advanced wound therapies should be considered. The number of new technologies, applied in VLUs treatment, has increased in the last years. These therapies include biophysical interventions such as ultrasound therapy, electrical stimulations, electromagnetic therapy, or phototherapy. Furthermore, stem cell therapies, biologic skin equivalents, platelet-rich plasma therapy, oxygen therapies, anti-TNF therapy, or negative pressure wound therapy are advanced venous ulcer therapeutic methods that may support the standard of care. Medical devices, such as a muscle pump activator, or intermittent pneumatic compression device, may be especially useful for specifific subgroups of patients suffering from VLUs. Some of the above-mentioned technologies require broader evidence of clinical effificacy and are still considered experimental therapies in dermatology.
Keywords: venous leg ulcers; advanced therapies; new technologies; wound treatment; experimental dermatology.
【摘要】 糖尿病足溃疡因神经血管病,处理难度大,截肢致残率高,其治疗方法也已成为医学难题。糖尿病足溃疡的管理已经从仅评估伤口状况发展到深层理解妨碍伤口愈合的分子学、细胞学层面上。针对糖尿病足溃疡伤口的修复过程,医护人员必须要识别影响伤口愈合的障碍以及通过选择合适的方法去除这些因素,从而为伤口创造最佳的愈合条件。 伤口床准备理论作为伤口管理方案可以加快伤口内源性愈合速度并加强其他治疗方法的效果。 本文针对糖尿病足溃疡伤口床准备理论的概念、内涵、分类及临床应用进行综述,并提出展望。
【关键词】 糖尿病足; 伤口床准备; 慢性伤口; 综述文献
【摘要】压疮常有潜行或窦道,甚至累及肌腱、骨或关节等支撑结构,如此容易导致伤口污秽、引流不畅而容易继发感染,成为压疮久治难愈的一个重要原因。恰当的清洗能够减少污秽物和细菌数量,去除影响愈合的障碍物而有助于压疮愈合。本文从压疮伤口清洗溶液和技术的研究进展、伤口清洗设备的研究进展、最新压疮护理指南中推荐的清洗建议和展望进行综述,期望对临床压疮护理有具体的指导意义。