Ueno Christiane, Hunt Thomas K, Hopf Harriet W
University of California, San Francisco, Wound Healing Laboratory, Departments of Anesthesia and Perioperative Care and Surgery, San Francisco, Calif 94143-0648, USA.
Plast Reconstr Surg. 2006 Jun;117(7 Suppl):59S-71S. doi: 10.1097/01.prs.0000225438.86758.21.
Despite major advances in surgical management and approaches, including aseptic techniques, prophylactic antibiotics, and laparoscopic surgery, surgical wound infection and wound failure remain common complications of surgery. In a review of the literature, the authors found that a growing body of literature supports the concept that patient factors are a major determinant of wound outcome after surgery. In particular, wounds are exquisitely sensitive to hypoxia, which is both common and preventable. Perioperative management can be adapted to promote postoperative wound healing and resistance to infection. The most important factors are fluid management, temperature management, pain control, increased arterial oxygen tension, and, as has been long recognized, appropriate sterile techniques and administration of prophylactic antibiotics. This article reviews how knowledge of and attention to physiology can improve quality of care in both acute and chronic wounds.
尽管在手术管理和方法方面取得了重大进展，包括无菌技术、预防性抗生素和腹腔镜手术，但手术伤口感染和伤口愈合不良仍然是常见的手术并发症。在对文献的综述中，作者发现越来越多的文献支持这样一种观点，即患者因素是手术后伤口愈合结果的主要决定因素。特别是，伤口对缺氧极为敏感，而缺氧既常见又可预防。围手术期管理可以进行调整，以促进术后伤口愈合和抗感染能力。最重要的因素是液体管理、体温管理、疼痛控制、提高动脉血氧张力，以及长期以来公认的适当无菌技术和预防性抗生素的使用。本文综述了对生理学的了解和关注如何能提高急慢性伤口的护理质量。
