Conservative or local treatment of burns - it is one of the few treatments that has come to us from ancient times, but is still widely used, along with the more modern and progressive methods. Using a conservative method of treating burns affected surfaces determined by the size and stage of wound healing. It should be noted that of all the "burn" of patients in hospitals, about 80% is exposed to conservative treatment, and if we consider that in the deep burns as primary therapeutic measures to prepare for the operation (to provide prizhivaniya dermal implants) used local treatment, coverage becomes sick and does 100%.
The basis of the conservative treatment of burns - aseptic bandage, affixed to prevent ingress of infection on the skin surface and primary treatment of burns, which is carried out either immediately or the next day at the first dressing change (if it is a small burn), or the second or third day, when serious injury, and there are all the signs of shock.
What is meant by primary treatment of burns? It includes four steps:
washing with antiseptic solutions adjacent to the wound surface of the skin. As antiseptics using 0.25% ammonia solution, furatsilin, 3% solution of boric acid, or just warm water and soap.
Remove fallen into the wound of foreign bodies, the remnants of the epidermis, fibrinous overlays, using tweezers, swabs and sponges.
repeated washing and drying antiseptic wound with sterile wipes.
dressing impregnated with an antimicrobial agent.
In certain cases (deep lesion) primary processing is done under anesthesia, and using both conventional analgesics, and, if the situation demands it - drugs.
All the above applies to the closed method of treatment of burns. If the patient is outside the hospital - it is the only possible method. In addition to infection control, the bandage is also protected from the adverse effects of the environment (temperature and humidity swings, getting foreign bodies, air currents), is indispensable for transporting the patient to a certain extent blunts pain, concentrates in okoloranevoy medicines, absorbs wound discharge . There is another, open method of treatment of burns. He was deprived of some of the shortcomings inherent in the closed (pain during dressing, bandaging and significant consumption of drugs), but quite demanding: a necessary condition for the creation of a sterile environment around the wound, which can be achieved only with the help of special equipment (UV irradiators) in hospital. This method is very useful for burns on the face and in the genital area, that is where the presence of bands desired.
Just as it is half empty or full of glass, there is a so-called semi-open or semi-closed, as you like, the. Its essence is as follows: after initial treatment is applied to the wound and bandage fixed finest bandage impregnated with an antibacterial agent. Then bandage exposed hot air (hair dryer) or IR radiation, so that it stuck to the wound. After 2-3 days the bandages are removed, the dressing is treated with a solution or betadine yodonata. And everything is dressing up to the final healing. And if there is suppuration, removed only area bands over the suppuration, the wound re-treated with an antiseptic and a bandage is closed again. After 2 weeks of dressing is removed.
As an antimicrobial for medical treatment, in addition to those already mentioned, use a solution of hydrophilic antibiotics dioksidina, chlorhexidine bigluconate and dressing in the form of aerosols (olazol, polkortolon TC), ointments and creams on the basis of water-soluble (Levosin, dioxidine). Selecting a particular antibiotic is determined species composition of microflora wounds. Keep in mind that bacterial resistance to antibiotics is formed faster than antiseptics (1-2 weeks).
We would also like to dwell on the drug on the basis of silver sulfadiazine in the form of ointments and creams. Currently, these drugs are literally are the best choice for the conservative treatment of burns. In our country, registered the following trade names that contain the pharmacologically active substance: sulfargin Estonian, Slovenian Dermazin, Bosnian argedin. The advantage of drugs based on silver sulfadiazine - a wide range of action, efficacy against both gram-negative microorganisms and gram-positive, and fungi-dermatophytes. The ointment is applied to the wound bed of 2-3 mm, covered by a bandage, and tied with bandages. Dressing changes made in a day.
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