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简述清创术

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2021-09-10 00:40
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1.适应证:新鲜创伤伤口。(1分)
2.禁忌证:化脓感染伤口不宜缝合。(1分)
3.准备工作(3分)(1)器械准备:消毒钳、持针器、镊子(有齿及无齿镊)、缝合线、剪刀、引流条或橡皮膜、外用生理盐水、纱布、棉垫、绷带、胶布、75%酒精等。(2)手术者洗手,戴无菌手套。
4.操作方法(15分)(1)清洗去污:①用无菌纱布覆盖伤口;②清创剪去毛发,除去伤口周围的污垢油腻(用肥皂水、松节油),用外用生理盐水清洗创口周围皮肤。(2)伤口的处理:①常规麻醉后,消毒伤口周围的皮肤,取掉覆盖伤口的纱布,铺无菌巾。换手套,穿无菌手术衣。②检查伤口,清除血凝块和异物。③切除失去活力的组织。④必要时可扩大伤口,以便处理深部创伤组织。⑤伤口内彻底止血。⑥最后再次用无菌生理盐水和双氧水反复冲洗伤口。(3)缝合伤口:①更换手术单、器械和手术者手套;②按组织层次缝合创缘;③污染严重或留有死腔时应置引流物或延期缝合皮肤。(4)伤口覆盖无菌纱布或棉垫,以胶布固定。


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