woundcleaning--Techniques伤口清洁---技术•Componentswhichneedtoberemovedfromwoundbed•需要从创面去除的部分•Surplusexudate多余渗出物•Necrotictissue坏死组织•Deadcells死亡细胞•Breadinggroundforbacteriaandcomponentswhichmightbesupportivetothedevelopmentofbiofilms.•细菌滋养环境以及可能会促进生物被膜形成的成分woundcleaning伤口清洁•Generalgoal•总体目标•Toremovedebriesandfroeignbodies.去除碎屑与异物•Necrotictissue坏死组织•Deadcells死亡细胞•Fibrin纤维蛋白•Toxins，MMP毒素，MMP•Foreignbodies(forinstanceremainsforpreviouslyuseddressings)•异物（例如先前使用的敷料）Woundcleaning--Techniques伤口清洁-----技术•Requirementsonwoundrinsingsolutions•对伤口冲洗液的要求•Shouldbesterilie无菌•Notcolored无色•Genteltocells/nontoxic细胞温和型/无毒•Bodytemperature(coolingdownwoundbedreducesorinactivatescellactivity)>28℃nofunction•体温（冷却创面、减少细胞活性或使其灭活）>28℃无效Woundcleaning伤口清洁•Ways•方法•Basiccleanningofwoundbed,woundedgesandsurroundingarea•对伤口创面、边缘以及周围进行基本清洗•Antibacteiracleanning抗菌剂清洗•Woundrinsing伤口冲洗•WoundcleaningWettodry干燥清洗伤口•Debridement清创术•Negtivepressure负压Woundcleaning伤口清洁----技术•CleanigwithRinsingsolution•采用冲洗溶液进行清洗•Saline生理盐水•Ringersolution林格氏液•Indication:Cleaningwound适应症：清洁伤口•Nontouchtechnique非接触技术Woundcleaning伤口清洁----技术•Cleanningwithantisepticsolution•采用消毒溶液进行清洗•Octenidin-di-hydrochlorid奥替尼啶盐酸化合物•Polyhexanid聚已缩胍•Iodine碘•Indication:Infectedandcontaminatedwound•适应症：感染伤口和污染伤口•Nontouchtechnique:Fromoutsidetocenterofwoundinordertoavoidfurtherspreadingofbacteriatothesurroundingarea.•非接触技术：从外围向中间清洗以避免细菌向周围进一步播散Woundcleaning--Antisepticsolution伤口清洁--消毒溶液•Octenidin-di-hydrochlorid奥替尼啶盐酸化合物•Polyhexanid聚已缩胍•Advantages优点•notcolored,notinacticatedbybodyfluids无色、不会被体液灭活•donotinitiateresistance,skinirritationandallergies不会引起抗药性、皮肤刺激或过敏•Disadvantages缺点•notavailableandreimbursedinmanycountries在许多地区不能使用而且不能报销•不能采用高压将奥替尼啶注入腔内加以应用•Bothshouldnotbeappliedoncartilageandincontactwithinternalorgans(abdominalcavity)二者均不能在软骨上运用，且不能与内部器官接触（腹腔）Woundcleaning--Antisepticsolution伤口清洁--消毒溶液•Iodine•Advantages优点•EffevtiveagainstGrampostiveandGramnegtivebacteria•可有效对抗革兰阳氏和阴性菌•Availableindifferentformsforapplication(ointment,lotions)•可以采用不同形式加以运用（软膏、洗液）•Disadvantages缺点•Colored(makeswoundassessmentdifficult)有色（难以对伤口进行评估）•Inactivatedbybodyfluids会被体液灭活•Sensitivitymightoccur可能会发生过敏•Systemicsideeffectsduetoabsortion吸收会导致全身副作用Wounddebridement清创术•Incaseofachronic,difficulttohealwoundcleaningcanbesupportedwithdifferentwaysofdebridement•在慢性、难愈合性伤口的清洁中可才采用不同的清创术进行支持治疗•Requirements要求：•Asgentleaspossible尽可能温柔•Asthoroughaspossible尽可能彻底•Assoonaspossible尽早Debridementopportunity清创时机•病情许可，越早越好•Illnesspermission,thesooner,thebetter•无明显感染表现，均可清创•Noapparentinfection,debridementperformance•已有感染，但伤口有异物或较多坏死组织，也可清创，清创后伤口暂不缝合•IftheWoundisinfected,buthaveaforeignbodyormuchnecrotictissue,wecanalsodebridement,anddonotwoun...
