Wongkietkachorn Apinut, Surakunprapha Palakorn, Titapun Attapol, Wongkietkachorn Nuttapone, Wongkietkachorn Supawich
Division of Plastic and Reconstructive Surgery, Department of Surgery, Faculty of Medicine, Mae Fah Luang University, Chiang Rai, Thailand.
Division of Plastic and Reconstructive Surgery, Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
Plast Reconstr Surg Glob Open. 2019 Mar 22;7(3):e2134. doi: 10.1097/GOX.0000000000002134. eCollection 2019 Mar.
In wound care, we usually focus nearly all of our efforts on the wound area while paying little attention to the periwound area. Although the periwound area may seem unimportant, it matters to patients. A female patient was admitted with a wound at the perianal area. Wound dressing was performed using standard wet-to-dry gauzes. The patient had several small complaints including irritant contact dermatitis, skin maceration, pain during dressing change, and fecal contamination to the wound. In this case, we ended up switching to a different method of wound dressing. We went from using wet-to-dry gauzes for the primary dressing to a hydrofiber with silver dressing and from gauze and Micropore as a secondary dressing to an adhesive sodium carboxymethylcellulose foam dressing. This resolved all complaints. The patient's satisfaction score using visual analog scale increased from 2 to 10 (out of 10 points). This example shows how even small details can make a significant difference in wound care. Because periwound care is often neglected, therapeutic algorithm that integrates major challenges in periwound care into wound healing strategies is proposed.
在伤口护理中，我们通常几乎将所有精力都集中在伤口部位，而很少关注伤口周围区域。尽管伤口周围区域可能看似无关紧要，但对患者来说却很重要。一名女性患者因肛周区域有伤口而入院。使用标准的湿 - 干纱布进行伤口敷料。患者有一些小问题，包括刺激性接触性皮炎、皮肤浸渍、换药时疼痛以及伤口受到粪便污染。在这种情况下，我们最终改用了不同的伤口敷料方法。我们从使用湿 - 干纱布作为主要敷料改为使用含银水凝胶敷料，从使用纱布和微孔胶带作为次要敷料改为使用粘性羧甲基纤维素钠泡沫敷料。这解决了所有问题。使用视觉模拟量表得出的患者满意度评分从2分提高到了10分（满分10分）。这个例子表明，即使是小细节在伤口护理中也能产生显著差异。由于伤口周围护理常常被忽视，因此提出了将伤口周围护理中的主要挑战纳入伤口愈合策略的治疗算法。
