DIET AND HEALTH
DIET AND HEALTH
复制标题
饮食与健康
DOI：
10.1136/bmj.2.4108.688
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发表时间：
1939
影响因子：
--
通讯作者：
John I. Bell
中科院分区：
文献类型：
--
作者：
J. Satsangi;D. Jewell;M. Parkes;John I. Bell
然后再将其放入溃疡的脱落层中。小的腐肉似乎被烧掉了;因此，“烧灼”这个词也被用来防止过于频繁的重复过程。较大的腐肉被尽可能多地从各个方面解放出来，并用剪刀剪去。在严重的情况下（发病迅速或有明显的全身症状），我会小心地切割任何可能出血的组织。切除邻近的死皮往往会暴露出意想不到的噬菌斑区域;事实上，当它没有植入现有的溃疡时，噬菌斑过程开始于水疱或未破裂的表皮之下，当然必须切除。经P.P.C.处理的部件呈现出刚涂上焦油的空洞的样子。怎么知道什么时候停止烧灼？通常通过研究病人的反应。(No使用麻醉剂）。在溃疡的每一部分继续烧灼，直到病人感到灼热。在烧灼完成之前很久气味就消失了。最后用1/5的碘仿-硼酸撒粉填充溃疡，用吸水羊毛-纱布是不必要的-包扎到第二天。在一般情况下，它会显示出一个大的颗粒表面，有几块噬菌斑，整个区域都有一层很好的碘仿。硼酸已随浆液性分泌物一起消失;它可能既有药物作用又有温和的促进分泌物的作用。在这种情况下，第三天最好烧灼溃疡中残留的脱落点的洞穴。需要两个以上P.P.C.的病例根据我的经验，这种治疗很少见
solution and then into the sloughing floor of the ulcer. Small sloughs seem to be burnt away by this; hence the word " cautery," which is also used to prevent too frequent repetition of the process. Larger sloughs are freed as much as possible on all sides and removed with scissors. In bad cases (with rapid onset or with pronounced general symptoms) I am chary of cutting any tissue which might bleed. The removal of dead skin in the neighbourhood often exposes unexpected areas of phagedaena; in fact, when it is not implanted on an existing ulcer, the phagedaenic process begins beneath a blister or unbroken epidermis which must, of course, be removed. The parts treated with P.P.C. take on the appearance of a freshly tarred cavity. How does one know when to stop cauterizing? Usually by studying the patient's response. (No anaesthetic is used.) The cautery is continued in each part of the ulcer until the patient feels the burning. The smell disappears long before the cauterization is completed. The ulcer is finally filled with 1 in 5 iodoform-boric dusting powder, covered with absorbent wool-gauze being unnecessary-and bandaged till the next day. In an average case it will then show a large granulating surface with a few patches of phagedaena, and a fine layer of iodoform over the whole area. The boric acid has gone with the serous discharge; it presumably mildly encourages this discharge as well as medicating it. In such cases the third day is best for cauterizing the burrows of the remaining sloughing 'spots in the ulcer. Cases needing more than two P.P.C. treatments are, in my experience, rare.