Triller Ciril, Huljev Dubravko, Planinsek Rucigaj Tanja
Univerzitetski klinicki centar Ljubljana, Kirurska klinika, Klinifki odjel za kirurske infekcije, Ljubljana, Slovenija.
Klinitka bolnica Sveti Duh, Klinika za kirurgiju, Centar za plasticnu i rekonstruktivnu kirurgiju, Zagreb, Hrvatska.
Acta Med Croatica. 2013 Oct;67 Suppl 1:81-7.
Chronic wounds are, due to the slow healing, a major clinical problem. In addition to classic materials, a great number of supportive wound dressings for chronic wound treatment, developed on the basis of new knowledge about the pathophysiological events in non-healing wounds, are available on the market. Today we know that modern wound dressings provide the best local environment for optimal healing (moisture, warmth, appropriate pH). Wound dressings control the amount of exudate from the wound and bacterial load, thus protecting local skin from the wound exudate and the wound from secondary infections from the environment. Using supportive wound dressings makes sense only when the wound has been properly assessed, the etiologic factors have been clarified and the obstacles making the wound chronic identified. The choice of dressing is correlated with the characteristics of the wound, the knowledge and experience of the medical staff, and the patient's needs. We believe that the main advantage of modern wound dressing versus conventional dressing is more effective wound cleaning, simple dressing application, painless bandaging owing to reduced adhesion to the wound, and increased absorption of the wound exudate. Faster wound granulation shortens the length of patient hospitalization, and eventually facilitates the work of medical staff. The overall cost of treatment is a minor issue due to faster wound healing despite the fact that modern supportive wound dressings are more expensive than conventional bandaging. The article describes different types of modern supportive wound dressings, as well as their characteristics and indications for use.
慢性伤口由于愈合缓慢，是一个主要的临床问题。除了传统材料外，基于对难愈合伤口病理生理事件的新知识开发的大量用于慢性伤口治疗的辅助性伤口敷料在市场上也有销售。如今我们知道，现代伤口敷料为最佳愈合提供了最佳的局部环境（湿度、温度、适宜的pH值）。伤口敷料可控制伤口渗出液的量和细菌负荷，从而保护局部皮肤免受伤口渗出液的影响，并保护伤口免受来自环境的继发感染。只有在对伤口进行了正确评估、明确了病因并确定了导致伤口慢性化的障碍之后，使用辅助性伤口敷料才有意义。敷料的选择与伤口的特征、医护人员的知识和经验以及患者的需求相关。我们认为，现代伤口敷料相对于传统敷料的主要优势在于伤口清洁更有效、敷料应用简单、由于对伤口的粘附性降低而包扎时无痛，以及伤口渗出液的吸收增加。更快的伤口肉芽形成缩短了患者住院时间，并最终便利了医护人员的工作。尽管现代辅助性伤口敷料比传统绷带更昂贵，但由于伤口愈合更快，治疗的总体成本是一个次要问题。本文描述了不同类型的现代辅助性伤口敷料及其特点和使用指征。
