Concerning wound treatment Opinion, criticism and latest information
Regarding wound treatment There are pros and cons and many opinions in the academic field.
This site does not deal with wound care that requires hospitalization or management of people with underlying illnesses, but mainly considers wounds that can be cared for by themselves in general daily life, school life, and sports. We are.
We believe that this is the correct view as a first aid before a doctor sees you.
On the above site, the academic and easy-to-understand contents are introduced in Q & A.
In order to avoid the misunderstanding that this is true for all medical settings, we will add new comments, criticisms and the latest information.
Japan Wound Healing Societyhttp://www.jswh.com/index.htmlWas established.
However, it is also true that the idea of disinfection, gauze, etc. still exists in any medical site.
More specifically, I would like to discuss and provide information on what kind of wounds really need disinfection, whether gauze can be applied, or rather.
When disinfection is necessary, it seems that there are many special cases in medicine.
Is there any consideration for general trauma?
In addition to my thoughts and clinical experience, I would like to convey various information about wound treatment so that the site does not communicate unilaterally and alone.
We recommend that you carefully read the judgments regarding the wound treatment of the referral HP linked within the site with reference to this site.
For your reference, here are the opinions we have received so far.
■ Disinfection and gauze are commonplace at first aid treatment sites. Wouldn't it be better to disinfect wounds and gauze just at the beginning?
■ Depending on the type of disinfection, may it be possible to disinfect wounds?
■ It is not natural to use clean gauze as a first aid because clean gauze is not used.
■ Wouldn't it be necessary to disinfect wounds with contaminated wounds or foreign objects if they cannot be removed by cleaning?
■ Actually, is the possibility of infection higher when not sterilized, or is the possibility of infection higher when sterilized?
■ Is wound healing delayed? As a result, isn't it better to disinfect the wound?
■ Isn't it safe to disinfect 1 times to reassure parents?
■ Beauty surgeons are not allowed to put out their mouths for wound care.
■ Actually, I often see patients who have undergone “disqualified cosmetic surgeons” in other hospitals. In such an example, it is certainly necessary to have a professional response that should be called “wound care”, but at least it is not a “cosmetic surgery” job.
In a sense, disinfection is both harmful and beneficial.
■ In a sense, gauze is both harmful and beneficial.
■ Don't say there is no consensus at the conference!
■ Use the trauma care methodology as evidence. Do not use it for postoperative wound care in cosmetic surgery.
■ If you sew it properly, you can disinfect it.
■ Even if you trouble a little, it will solve your time without having to mess with complicated protocols.
■ Examples of direct application of gauze include extensive burns in the subacute phase. Since a large amount of exudate comes out from a wide area, it will flow no matter how much chemical is applied, and it will not stick even if gauze is applied directly.
Expensive wound dressing is rather unable to absorb the exudate and needs to be replaced in a few hours. For this reason, it is important to apply burn gauze directly and seal it with drape to reduce exudate. Large amounts of exudate caused hypoproteinemia and low-capacity shock and are fatal. Of course, if exudate is reduced, another drug or material will be placed under the gauze.
A large amount of necrotic tissue remains attached, but since the necrotic area is not fixed, early debridement is performed (although some universities recommend early debridement), a large amount of soft tissue is removed. In order to lose and significantly lower the patient's quality of life, it is necessary to look for a certain period of time, during which the risk of infection increases.
Large amounts of exudate and necrotic tissue can be a source of pathogens, so direct disinfection of the wound is essential to reduce the absolute amount.
■ The use of antiseptics for intractable intractable ulcers is controversial, but if the protracted healing factor is clearly infection, the use of antiseptics is still essential.
■ It is important to seek the optimal treatment for each case while always discussing it in the field.
Even if the evidence is obscured by unclear principles, it is the patient who is in trouble.
■ It often takes time to re-educate the comedy, which is an expanded interpretation of what XX teacher says.
■ Professor of Plastic Surgery at Sakai University has sounded a warning against the recent “disinfection harmful theory”.
Although there are various opinions, I would like to say from the clinician's standpoint that direct disinfection of scratches and cuts is harmful.
Personally, I think it is better to control the infection with antibiotics than to repeat disinfection frequently and cause pain in the patient.
Of course, after removing foreign material from the wound surface and debridement.
Abuse of antibiotics! You may be asked, but which one you want to receive ... Again, avoid disinfection.
Gauze is also a problem if it destroys a moist environment, but it seems to be possible to use it to cover patients with peace of mind because of exudate control (although rare in outpatients).
However, there are few opportunities for gauze with recent superior wound dressings.