Kluwe Wolfram
Med Monatsschr Pharm. 2015 Feb;38(2):48-53; quiz 55-6.
Skin cuts and lacerations are frequent injuries. A perfect result of the treatment is going without saying for the patient and its relatives. But there are some aspects to note for an adequate wound management. The main aims of wound management are clear: assist in hemostasis, to avoid infection and pain, and to ensure an esthetically pleasing scar. For these we have to treat not only the wound. Taking care for the hole patient and treating the sore pain and preventing painfull manipulations is the goal for the patients satisfaction. The basic aspects of wound healing and wound management will be described. Sutures, tissue adhesives, staples, and skin-closure tapes are options in the outpatient setting. Although suturing is the preferred method for laceration repair, tissue adhesives are similar in patient satisfaction, infection rates, and scarring risk in low skin-tension areas and may be also more cost-effective. Patient education and appropriate procedural coding are important after the repair. Please do not forget in every case to ask for the tetanus immunization and to think about an antibiotic therapy in case of human or animal bites and for wounds in risk areas and with contamination.
皮肤切割伤和撕裂伤是常见的损伤。治疗取得完美结果对患者及其亲属来说不言而喻。但对于恰当的伤口处理,有一些方面需要注意。伤口处理的主要目标很明确:协助止血、避免感染和疼痛,并确保形成美观的瘢痕。为此,我们不仅要处理伤口。照顾好整个患者、治疗剧痛并避免痛苦的操作,是让患者满意的目标。将描述伤口愈合和伤口处理的基本方面。缝线、组织粘合剂、吻合钉和皮肤闭合胶带是门诊环境中的选择。虽然缝合是撕裂伤修复的首选方法,但在皮肤张力低的区域,组织粘合剂在患者满意度、感染率和瘢痕形成风险方面与之相似,而且可能更具成本效益。修复后患者教育和恰当的程序编码很重要。在每种情况下都不要忘记询问破伤风免疫情况,并考虑在发生人或动物咬伤以及伤口位于危险区域或有污染时进行抗生素治疗。