Wound healing and wound infection - What surgeons and anesthesiologists can do
Wound healing and wound infection - What surgeons and anesthesiologists can do
复制标题
DOI：
10.1016/s0039-6109(05)70570-3
复制
发表时间：
1997-06-01
影响因子：
3.1
通讯作者：
Hopt, HW
中科院分区：
文献类型：
--
作者：
Hunt, TK;Hopt, HW
通常可以通过简单、廉价、容易获得的方法来促进伤口愈合并预防伤口感染。术前评估营养不良、血管收缩、高血糖和类固醇使用等愈合障碍，以便在手术前进行纠正。术中，外科医生应专注于手术技术、适当的抗生素使用和预防血管收缩（即容量、升温）。术后重点应是通过缓解疼痛、保暖和充分容量复苏来预防血管收缩，以及维持营养和正常血糖。这些方法也适用于慢性伤口。此外，维持湿润环境、通过交感神经阻滞或加温纠正局部血管痉挛以及通过积极清创或高压氧治疗刺激血管生成可增强慢性伤口的愈合。
Wound healing can be enhanced and wound infections tan be prevented, often by simple, inexpensive, readily available means. Preoperative evaluation for impediments to healing such as malnutrition, vasoconstriction, hyperglycemia, and steroid use allows correction before operation. Intraoperatively, the surgeon should concentrate on surgical technique, appropriate antibiotic use, and prevention of vasoconstriction (i.e., volume, warming). Postoperatively, the focus should be on prevention of vasoconstriction through pain relief, warming, and adequate volume resuscitation, and on maintenance of nutrition and normoglycemia. These approaches also apply to chronic wounds. Additionally, maintenance of a moist environment, correction of local vasospasm with sympathetic blockade or warming, and stimulation of angiogenesis through aggressive debridement or hyperbaric oxygen therapy enhance healing of chronic wounds.