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[原发性和继发性伤口处理原则]

[Principles of primary and secondary wound management].

作者信息

Schwemmle K, Linder R

机构信息

Klinik für Allgemein-und Thoraxchirurgie, Justus-Liebig-Universität, Giessen.

出版信息

Chirurg. 1995 Mar;66(3):182-7.

PMID:7750387
Abstract

Wound management includes treatment of injuries, chronically open wounds of various origin, and incisions. Despite successful primary wound healing has good functional and cosmetic results, primarily closure should not be forced by raising wound tension or in wounds with increased risk of infection, respectively. Standards of trauma wound debridement according to location and type of wound are still in force. Anatomically incorrect type of surgical incisions may disturb wound healing. Sutures of the subcutaneous tissue are associated with increased risk of infection and should therefore be avoided. Alternatively, vacuum drainages may be used. Antibiotics should only be given exceptionally and if so, not as a local application. In case of chronically open wounds, underlying diseases should be treated, respectively. Moist wound healing using occlusive dressings has been established successfully in local management of chronic wounds.

摘要

伤口处理包括对各种损伤、不同病因的慢性开放性伤口以及切口的治疗。尽管一期伤口愈合成功会带来良好的功能和美观效果,但不应通过增加伤口张力来强行进行一期缝合,对于感染风险增加的伤口也不应如此。根据伤口的位置和类型制定的创伤伤口清创标准仍然有效。手术切口的解剖结构不正确可能会干扰伤口愈合。皮下组织缝合会增加感染风险,因此应避免。或者,可以使用负压引流。抗生素仅在特殊情况下使用,并且不应局部应用。对于慢性开放性伤口,应分别治疗潜在疾病。在慢性伤口的局部处理中,使用封闭敷料的湿性伤口愈合方法已成功确立。

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