Precautions in wound nursing

Standardized debridement should be done first to reduce the risk of infection, and wet and dry nursing schemes should be selected according to the types of wounds to avoid folk prescription stimulation and artificial secondary injury. This is a universal conclusion summarized by combining traditional surgical experience with modern wet healing concept.

Last year, when I was in emergency surgery, I met three or four patients who "reworked" the wound by themselves. The most impressive one was a 20-year-old college student who fell his palm while riding bike-sharing, went home and put a band-aid on the wound for three days. When he came, his palm was swollen like steamed bread, and the band-aid was full of yellow-green pus. When he was debrided, the young man shook my white coat sleeve and said that he would not be blind if he had known.

Speaking of which, someone will definitely ask: I heard the doctor say that the wound should be dried for air, and some people said that it should be wrapped for moisturizing. Which is right? In fact, both of these statements are correct, but the applicable scenarios are different. The older generation of surgeons used to make the wound dry and scab because there was no good moisturizing dressing before, and the dry environment could reduce bacterial reproduction, which was suitable for the wound with much exudation and heavy pollution, and it was convenient to observe the exudation. The concept of wet healing, which has been popularized in recent 20 years, means that clean superficial wounds without obvious infection are covered with sterile dressings or moisturizing dressings such as hydrocolloids, and keeping the moist environment can make epithelial cells crawl faster, heal nearly one-third faster than airing, and it is not easy to leave raised scars. For example, if you just scratch your knee while walking, there is little seepage. Wash the sediment with normal saline, apply an iodophor to eliminate the poison, or put a thin hydrocolloid dressing on it, or it doesn't matter if it is dry, as long as you don't get dirty; However, if you cut your finger by chopping vegetables, the wound is a little deep and there is a lot of oozing blood, it is best to wrap it with sterile gauze and change it once a day to observe whether the oozing fluid becomes turbid and the wound is red and swollen.

I sorted out several nursing pits that everyone is most likely to step on, which is clear at a glance:

Oh, by the way, there is another situation in which many people are caught, that is, when the wound is almost healed, it itches like hell and you can't help scratching. I have a patient's leg bruised, and it will get better soon. I grabbed it unconsciously when I slept at night, and directly took off the scab. The wound that was almost flat was bleeding again, and finally left an obvious pigment print, which only disappeared in half a year. In fact, itching is the growth of new nerve endings, which is a normal phenomenon. You can't help but rub it gently with a clean cotton swab twice, or apply it with a cold towel for half a minute, just don't scratch hard.

There are also some wounds that can never be treated at home, such as deep and narrow wounds pierced by rusty nails and dirty wooden thorns. This anoxic environment is easy to breed tetanus bacilli. You should go to the hospital for debridement at the first time and get a tetanus shot within 24 hours. Anyone who is bitten by cats, dogs and wild animals, regardless of bleeding, should go to the CDC to evaluate whether to get rabies vaccine. Don't be lucky.

In fact, wound care is really not so complicated. The core is not to fiddle around. If you are not sure how to handle your own wound, go to the community hospital downstairs to have a look at the nurse, and change the medicine for a dozen dollars, which is much more reliable than trying the remedies blindly and finally leaving scars and infections. After all, no one wants a good wound and finally leaves an ugly scar, right?