Добавил:
Sekretar
kiopkiopkiop18@yandex.ru
t.me/Prokururor I Вовсе не секретарь, но почту проверяю
Опубликованный материал нарушает ваши авторские права? Сообщите нам.
Вуз:
Предмет:
Файл:Ординатура / Хирургия / @xirurgi_2025 / @xirurgi_2025 - 716 - файл
.pdf
160 Appendix A
https://t.me/med1917
Table A-8. Staple Removal on a Wound Model
• Keep the tool closed and move away from the wound with the staple engaged in the tool
(Figure A-4D).
Figure A-4D
• Place each removed staple on gauze and count the total to ensure removal of all staples.
(continued)
REFERENCES
1. Ediger MJ. Closure options for skin lacerations. Int J Athl Ther Train. 2010;15(2):19-22.
2. Forsch RT. Essentials of skin laceration repair. Am Fam Physician. 2008;78(8):945-951.
3. Honsik KA, Romeo MW, Hawley CJ, Romeo SJ, Romeo JP. Sideline skin and wound care for
acute injuries. Curr Sports Med Rep. 2007;6(3):147-154.
4. Flanagan KW, Cuppett M. Medical Conditions in the Athlete. Human Kinetics; 2017:97-121.
5. Rose J, Tuma F. Sutures and Needles. StatPearls; 2021. Accessed June 17, 2022. https://www.
ncbi.nlm.nih.gov/books/NBK539891/
6. Yag-Howard C. Sutures, needles, and tissue adhesives: A review for dermatologic surgery.
Dermatol Surg. 2014;40(suppl 9):S3-S15.
7. Hochberg J, Meyer KM, Marion M. Suture choice and other methods of skin closure. Surg Clin
North Am. 2009;89(3):627-641.
8. Hussey M, Bagg M. Principles of wound closure. Oper Tech Sports Med. 2011;19(4):206-211.
9. Suturing 101: A stitch in time… Provider Practice Essentials. Accessed June 20, 2022. https://
ppemedical.com/blog/suturing-101-a-stitch-in-time/
10. Dumville JC, Gray TA, Walter CJ, et al. Dressings for the prevention of surgical site infection.
Cochrane Database Syst Rev. 2016;12:CD003091.
11. Copeland-Halperin LR, Via y Rada MLR, Levy J, Shank N, Funderburk CD, Shin JH. Does
the timing of postoperative showering impact infection rates? A systematic review and metaanalysis. J Plast Reconstr Aesthet Surg. 2020;73(7):1306-1311.
B
https://t.me/med1917
WOUND CARE 101
INFOGRAPHIC
161
162 Appendix B
https://t.me/med1917
C
https://t.me/med1917
CLINICAL APPLICATION TABLE
163
164 Appendix C
https://t.me/med1917
Wound Type Cleansing Debridement Dressing
Abrasion Wound bed:
Irrigation with
normal saline or
potable tap water
at the appropriate
temperature;
showering with
potable tap water
at the appropriate
temperature.
Periwound tissue:
Irrigation with
normal saline or
potable tap water;
scrubbing with
normal saline,
potable tap
water, or topical
antiseptic.
Avulsion Wound bed:
Irrigation with
normal saline or
potable tap water.
Do not use tap
water if bone or
tendon is exposed.
Avulsed tissue:
Gentle irrigation
with normal saline.
Blister (closed,
intact roof not
impacting daily
activities)
Not indicated Not indicated Secondary: Nonsterile hydrogel,
Irrigation with
normal saline or
potable tap water;
wet to moist;
scrubbing with
normal saline
or potable tap
water if heavily
contaminated;
conservative
a
autolytic
sharp;
with occlusive
dressings
Not indicated Primary: Woven or nonwoven sterile
Primary: Occlusive (alginate, film,
foam, hydrogel, and hydrocolloid),
nonocclusive (woven or nonwoven
sterile gauze, nonadherent pads,
and adhesive strips and patches)
based on wound, dressing, and
patient factors.
Secondary: Adhesive gauze or
nonadherent, self-adherent, or
adherent tapes and wraps based
on wound, dressing, and patient
factors.
gauze premoistened with normal
saline.
Secondary: Woven or nonwoven
sterile gauze.
Avulsed tissue: Woven or nonwoven
sterile gauze premoistened with
normal saline. Wrap the tissue and
place it in a watertight bag. Place
the bag in ice water or onto an ice
bag, avoiding direct contact of the
tissue with the ice. Refer the patient
and avulsed tissue to a physician for
further assessment and treatment.
nonocclusive (woven or nonwoven
gauze, nonadherent pads, and
adhesive strips and patches),
adhesive gauze or nonadherent,
self-adherent, or adherent tapes and
wraps based on wound, dressing,
and patient factors.
continued
Clinical Application Table 165
https://t.me/med1917
Wound Type Cleansing Debridement Dressing
Blister (closed,
intact roof
impacting daily
activities)
Blister roof and
periwound
tissue: Scrubbing
with topical
antiseptic before
debridement.
Wound bed:
Irrigation with
normal saline or
potable tap water
after debridement.
Blister (open) Wound bed:
Irrigation with
normal saline or
potable tap water
at the appropriate
temperature.
Periwound tissue:
Irrigation with
normal saline or
potable tap water;
scrubbing with
normal saline,
potable tap
water, or topical
antiseptic.
Blister roof:
Conservative
a
Create
sharp.
a small incision
in the roof with
a sterile, sharp
instrument
and drain fluid.
Remove the
roof by cutting
along the border
between the
viable and
nonviable tissue.
Irrigation with
normal saline or
potable tap water;
wet to moist;
scrubbing with
normal saline
or potable tap
water if heavily
contaminated;
conservative
a
autolytic
sharp;
with occlusive
dressings
Primary: Occlusive (alginate, film,
foam, hydrogel, and hydrocolloid),
nonocclusive (woven or nonwoven
sterile gauze, nonadherent pads,
and adhesive strips and patches)
based on wound, dressing, and
patient factors.
Secondary: Adhesive gauze or
nonadherent, self-adherent, or
adherent tapes and wraps based
on wound, dressing, and patient
factors.
Primary: Occlusive (alginate, film,
foam, hydrogel, and hydrocolloid),
nonocclusive (woven or nonwoven
sterile gauze, nonadherent pads,
and adhesive strips and patches)
based on wound, dressing, and
patient factors.
Secondary: Adhesive gauze or
nonadherent, self-adherent, or
adherent tapes and wraps based
on wound, dressing, and patient
factors.
continued
166 Appendix C
https://t.me/med1917
Wound Type Cleansing Debridement Dressing
Incision and
laceration
Wound bed:
Irrigation with
normal saline or
potable tap water.
Do not use tap
water if bone or
tendon is exposed.
Periwound tissue:
Irrigation with
normal saline or
potable tap water;
scrubbing with
normal saline,
potable tap
water, or topical
antiseptic.
Irrigation with
normal saline
or potable tap
water. Do not
use tap water if
bone or tendon is
exposed.
Primary with adequate tissue
approximation: Occlusive
(alginate, film, foam, hydrogel,
and hydrocolloid), nonocclusive
(woven or nonwoven sterile gauze,
nonadherent pads, and adhesive
strips and patches) based on the
wound (superficial- to full-thickness),
dressing, and patient factors.
Secondary: Adhesive gauze or
nonadherent, self-adherent, or
adherent tapes and wraps based
on wound, dressing, and patient
factors.
Primary with tissue approximation
required: Dermal adhesives and
wound closure strips based on
the wound (minimal skin tension),
dressing, and patient factors.
Secondary: Woven or nonwoven
sterile gauze, nonadherent pads,
nonadherent or self-adherent wraps,
and hypoallergenic skin tapes based
on the wound, dressing, and patient
factors.
Primary with tissue approximation
required: Sutures and staples based
on the wound (high skin tension),
dressing, and patient factors.
Secondary: Woven or nonwoven
sterile gauze, nonadherent pads,
nonadherent or self-adherent wraps,
and hypoallergenic skin tapes based
on the wound, dressing, and patient
factors.
Possible referral to a physician for
advanced cleansing, debridement,
and wound closure.
continued
Clinical Application Table 167
https://t.me/med1917
Wound Type Cleansing Debridement Dressing
Puncture Wound bed: Gentle
irrigation with
normal saline or
potable tap water.
Periwound tissue:
Irrigation with
normal saline or
potable tap water;
scrubbing with
normal saline,
potable tap water,
or topical antiseptic
Consider the
removal of visible,
small objects
with sterile
instruments.
a
caution to avoid
pushing objects
deeper into the
wound.
Do not remove
large or brokenoff embedded
objects from the
wound.
Primary with no cavity: Occlusive
(alginate, film, foam, hydrogel,
and hydrocolloid), nonocclusive
(woven or nonwoven sterile gauze,
Use
nonadherent pads, and adhesive
strips and patches) based on the
wound, dressing, and patient
factors.
Secondary: Adhesive gauze or
nonadherent, self-adherent, or
adherent tapes and wraps based
on wound, dressing, and patient
factors.
Primary with cavity: Woven,
nonwoven, and impregnated sterile
gauze rolls and strips based on
the wound, dressing, and patient
factors.
Secondary: Nonocclusive (woven
or nonwoven sterile gauze,
nonadherent pads, and adhesive
strips and patches) based on
wound, dressing, and patient
factors.
Primary with embedded object:
Woven or nonwoven sterile gauze.
Wrap gauze around the object,
immobilize the object or joint,
and refer to a physician for further
assessment and treatment.
a
Clinicians should review state laws and practice acts before performing this technique.
https://t.me/med1917
FINANCIAL DISCLOSURES
https://t.me/med1917
Dr. Joel W. Beam reported no financial or proprietary interest in the materials presented herein.
Dr. Bernadette Buckley reported no financial or proprietary interest in the materials presented
herein.
Dr. Mario Ciocca reported no financial or proprietary interest in the materials presented herein.
169
Соседние файлы в папке @xirurgi_2025