Dowsett Caroline
Tissue Viability, Newham Primary Care Trust, London.
Br J Community Nurs. 2002 Jun;7(6 Suppl):33-4, 36-8. doi: 10.12968/bjcn.2002.7.Sup1.12959.
Many patients are now having minor surgical procedures carried out in the community and those patients who undergo surgery in hospital are likely to be discharged earlier due to increasing pressure on hospital beds. This article discusses the management of surgical wounds healing by both primary and secondary closure, in the community setting. Understanding the complex process of wound healing is essential if nurses are to recognize abnormalities and select appropriate treatments for patients. The stages of wound healing will be discussed in detail, including the patient's presentation. Factors that influence this process within the patient (e.g. age, nutrition, medication and pain) and those at the wound bed (e.g. exudate, tissue type and infection) will be highlighted. Choosing the correct type of surgical wound dressing for the type of wound can contribute to wound healing, patient comfort and the cost-effectiveness of treatment. Factors that need to be taken into consideration when choosing a dressing will be outlined and suggestions made for the type of dressings that would be most appropriate. The importance of accurate and detailed documentation will be highlighted as part of this process.
现在许多患者在社区接受小型外科手术，而由于医院病床压力不断增加，那些在医院接受手术的患者可能会更早出院。本文讨论了在社区环境中通过一期和二期缝合愈合的手术伤口的管理。如果护士要识别异常情况并为患者选择合适的治疗方法，了解伤口愈合的复杂过程至关重要。将详细讨论伤口愈合的阶段，包括患者的表现。将强调影响患者体内这一过程的因素（如年龄、营养、药物和疼痛）以及伤口床的因素（如渗出液、组织类型和感染）。为伤口选择正确类型的外科伤口敷料有助于伤口愈合、患者舒适和治疗的成本效益。将概述选择敷料时需要考虑的因素，并对最合适的敷料类型提出建议。准确和详细的记录的重要性将作为这一过程的一部分得到强调。
