Briefly describe the procedure for debridement? Describe the requirements for debridement.

The requirements for debridement are: removal of dirt and foreign bodies from the wound; complete hemostasis; Excision of necrotic tissue that has lost viability.

Answer] :d small and deep wounds, after the excision of the wound margin and subcutaneous tissue, the wound stool rubber can be appropriately enlarged to facilitate deep disturbance resistant tissue cleaning. All other options are correct.

Surgical procedure].

1.Cleaning and decontamination is divided into two steps: cleaning** and cleaning the wound.

Cleaning**: Cover the wound with sterile gauze and wipe off the oil around the wound** with gasoline or ether. The surgeon washes his hands and wears gloves according to the usual method, changes the gauze covering the wound, scrubs with a soft brush dipped in disinfectant soap and water**, and rinses with cold boiled water.

Then switch to another brush and brush again, and dry with sterilized gauze**. Brush twice for about 10 minutes.

Cleaning the wound: Remove the gauze covering the wound, rinse the wound with normal saline, and gently remove dirt, blood clots, and foreign bodies from the wound with antiseptic forceps or a small gauze ball.

2.Clean the wound Anesthesia, wipe dry**, disinfect with iodine tincture and alcohol**, and cover with a sterilized surgical towel to prepare for surgery. The surgeon can clean the wound after soaking his hands with alcohol or Xinjieer Killer Solution, wearing a surgical gown, and wearing gloves.

For superficial wounds, the irregular edges around the wound can be excised, the incision surface can stop bleeding, blood clots and foreign bodies can be eliminated, and the devitalized tissue can be removed.

Vascular debridement.

and significantly contusioned wound tissues (including ** and subcutaneous tissues, etc.), and rinse with sterile saline at any time.

For deep wounds, the inactive fascia and muscle should be completely excised (if the muscle section does not bleed, or the forceps are not contracted with forceps, it means that it has been necrotic), but the viable muscle should not be excised, so as not to affect the function of the excision too much. To treat deeper wounds, the wound may sometimes be enlarged and the fascia may be cut to clean the wound until the tissue with better blood circulation is revealed.

If there is a comminuted fracture at the same time, the fracture fragments should be kept as much as possible; Small bone fragments that have become free from the periosteum should be removed.

If the entrance and exit of the superficial penetrating wound are close, the tissue bridge between the wound tracts can be cut open to turn two wounds into one. If the wound is too deep, the deep part should not be cleaned from the entrance, but from the side incision.

If the wound is bleeding actively, it can be stopped by using a hemostat or temporary ligation before debridement. Re-ligation is required to remove contaminating threads when the wound is to be cleaned. Bleeding can be stopped by compression with warm saline gauze or with a local hemostatic agent such as thrombin.

3.Repair the wound After debridement, wash the wound again with normal saline. Then, according to the specific conditions such as the degree of contamination, the size and depth of the wound, it is decided whether the wound is open or sutured, and whether it is a one-stage or delayed suture.

Wounds that have been cleaned for less than 12 hours can be sutured in one stage; For large and deep wounds, drainage strips should be placed at the time of primary suturing; Wounds that are heavily polluted or cannot be completely debrided in special parts should be postponed for suturing, that is, after debridement, Vaseline gauze strips should be placed in the wound for drainage, and after 4 7 days, if the wound tissue is ruddy, there is no infection or edema, then suture is made.

The head and face are rich in blood vessels, the healing force is strong, and although the injury time is long, as long as there is no obvious infection, primary suture should still be sought.

When suturing the wound, there should be no dead space and the tension should not be too great. Vital vascular injuries should be repaired or anastomized; The ruptured tendon and nerve trunk should be trimmed and sutured. Exposed nerves and tendons should be covered with **; Open joint cavity injuries should be thoroughly washed and sutured; Open injuries to the thoracoabdominal cavity should be thoroughly debrided and a drain or strip placed.

Answer]: B debridement is to decontaminate a fresh and open contaminated wound, remove the damaged and dead tissue, suture the wound, minimize contamination, and even turn it into a clean wound, so as to achieve a first-stage healing, which is conducive to the recovery of the function and shape of the injured part. The first step in debridement is cleaning, when the field of vision is clear, and then hemostasis is performed.

Debridement is to clean and decontaminate fresh open contaminated wounds, remove blood clots and foreign bodies, remove lifeless tissues, suture wounds, minimize contamination, and even turn them into clean wounds to achieve first-stage healing, which is conducive to the recovery of the function and shape of the injured parts. (1) Indications: Fresh wound wounds. (2) Contraindications: Purulent infected wounds should not be sutured.

c) Preparation 1Preparation of instruments Sterile forceps, needle holders, forceps (toothed and toothless), sutures, scissors, drainage strips or rubber films, topical saline, gauze, cotton pads, bandages, adhesive tapes, 75% alcohol, etc. 2.

Surgeons wash their hands and wear gloves. (4) Operation method 1Wash and decontaminate the wound with sterile gauze; Cut the hair, remove the dirt around the wound (with soapy water, turpentine), and wash the wound area with topical saline**.

2.Treatment of the wound After routine anesthesia, disinfect the ** around the wound, remove the gauze covering the wound, and spread a sterile towel. Change gloves and wear a sterile surgical gown; Examination of the wound to remove blood clots and foreign bodies; excision of viable tissue; If necessary, the wound can be enlarged to allow for treatment of deep traumatic tissue; Complete hemostasis in the wound; Finally, the wound is repeatedly rinsed with sterile saline and hydrogen peroxide.

3.Suturing the wound Replacement of surgical drapes, instruments and surgical gloves; suture the wound margin according to the tissue level; When contamination is severe or there is a dead space, drainage should be placed or suturing should be delayed**. 4.

The wound is covered with sterile gauze or cotton pads and secured with adhesive tape.

1.Strictly aseptic operation. 2.

Wash thoroughly with a large amount of sterile saline, and pay attention to cleaning the wound of foreign bodies, mud, dust, etc., especially for large and deep wounds. 3.Severely damaged or necrotic tissues should be removed as much as possible, but care should be taken to preserve tissues and organs such as broken bones, nerves, and important blood vessels as much as possible.

4.Postoperative prophylactic antibiotics with intramuscular tetanus antitoxin within 24 hours. 5.

Observe closely after surgery.