Attinger C E, Bulan E, Blume P A
Georgetown Limb Center, Georgetown University Medical Center, Washington, District of Columbia, USA.
Clin Podiatr Med Surg. 2000 Oct;17(4):599-630.
No wound can heal in an orderly fashion unless it is clean, healthy, and free of infection. Débridement is key in achieving this goal providing that: (1) the wound is adequately vascularized, (2) the proper antibiotics are on board, and (3) all other medical aspects of the patient have been addressed. Surgical débridement is the quickest and most efficient way of getting the wound ready for healing. Exciting new products such as growth factor, hyperbaric oxygen, skin graft substitutes, and the V.A.C. can then be selectively applied to accelerate wound healing. For those wounds that require more than closure by secondary intention, plastic surgical techniques can then be used to provide a functional and effective wound closure.
除非伤口清洁、健康且无感染,否则无法有序愈合。清创术是实现这一目标的关键,前提是:(1)伤口有足够的血管供应,(2)使用了合适的抗生素,(3)患者的所有其他医疗方面问题均已得到解决。手术清创是使伤口为愈合做好准备的最快且最有效的方法。然后可以选择性地应用一些令人兴奋的新产品,如生长因子、高压氧、皮肤移植替代品和负压封闭引流技术,以加速伤口愈合。对于那些需要不止二期愈合的伤口,可以采用整形手术技术来实现功能性且有效的伤口闭合。