PCO wounds - primary surgical treatment
Author: Surgeon Denisov MM
Primary surgical treatment of wounds (PHO) is a series of surgical procedures aimed at preventing wound infections and creating the necessary conditions for the most effective wound healing.
As a rule, PHO consists of several stages:
· Visual inspection of the wound
· Thorough wound care
· Dissection of the wound
· Excision within healthy tissue
· Cessation of bleeding
· Suture closure and drainage
Visual inspection of the wound is necessary to determine the degree of damage, the type of wound and its contamination. Based on the data obtained, a plan for its rehabilitation is modeled.
Thorough treatment of the wound as an independent manipulation is carried out in cases of minor injuries (for example, superficial incised wounds). For the implementation of the event, the surgeon cleans the skin around the wound from contamination. For these purposes, use a cotton swab, which is moistened with an alcohol solution or septocide. After cleaning, the wound edges are smeared with alcohol solutions of iodine (iodonate, iodinol). Asking how to treat the wound , you can use the above drugs, as well as chlorhexidine and other antiseptics. At the end of the procedure, an aseptic bandage is applied to the surface of the wound. This manipulation is carried out in all medical institutions.
If it is not possible to conduct sufficient toilet wounds, the dissection of the edges is carried out. Depending on the general condition of the patient, such manipulation is carried out under local (infiltrative) or general anesthesia. Important is the use of hydrogen peroxide 3%. Due to its pharmacological properties, this drug decomposes to active oxygen when interacting with tissues, leading to the formation of foam, which acts as an adsorbent for microorganisms and pollutants in the wound. After treatment with the peroxide solution, visible foreign bodies are removed from the wound using tweezers.
Excision of a wound within healthy tissue is called complete. Partial is called in case there is a liquidation of smashed or dead tissues. Wounds localized on the face, hands, as a rule, do not excise because of a large cosmetic defect. It is also contraindicated excision of the wound edges, if they determine the presence of large vessels and nerve trunks.
After all the manipulations are done, the bleeding is stopped by bandaging (ligating) large vessels and cauterizing (coagulating) smaller ones. When large-caliber vessels are damaged, a special vascular suture is imposed on them.
The final stage of primary surgical treatment is the closure of the wound tightly. Treatment of purulent wounds has its own distinctive feature. It consists in the absence of the need for wound closure, the edges of the wound are simply tightened with ligatures, but it is imperative to create ways for the discharge of the discharge wound, in order to avoid repeated suppuration. This manipulation is called drainage. Drainage is a narrow tube, one end located in the wound, the other - outside it. Active drainage can also be used to inject antiseptic agents into the wound and exudate.
At the discretion of the surgeon, in the event of a risk of developing a wound infection, and subsequently sepsis, antibiotic therapy is prescribed for up to 7-10 days. As a rule, broad-spectrum antibiotics are used to suppress opportunistic flora.
Author: doctor Deryushev A.N.
The treatment of purulent wounds is a very responsible matter, since the presence of pus in the wound as a result of infection means that the wound may contain closed cavities, dead tissues that are deprived of blood supply, and it is even possible that there are foreign bodies in the wound that got there during an injury.
Author: Dr. Jordan A.V.
More often, injuries of a traumatic nature in the tongue have the appearance of superficial wounds resulting from biting (during chewing or an epileptic seizure) injury by the sharp edge of a broken or carious tooth, bone from food or sharp objects such as a fork, pencil, etc.
Author: Surgeon Denisov MM
Cut wounds are called that were caused by sharp cutting objects (for example, a knife). This type of wound is characterized by large bleeding, pain, divergence of the edges. Bleeding depends on the number, as well as on the nature of the damaged vessels.
Purulent wound is characterized by the presence of pus, tissue necrosis, the development of microbes, tissue swelling, absorption of toxins. The principles of treatment of purulent wounds are based on the study of the processes occurring in a wound during its healing and conditions conducive to regeneration. Tasks of treatment: removal of pus and necrotic tissues; reduction of edema and exudation; fight against microorganisms.