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Wound Healing and Ulcers of the Skin - part 6

Không cần thiết ngâm chân có thể dẫn đến ngâm, mà không phải là mong muốn, đặc biệt là đối với bệnh nhân tiểu đường. Một hình thức đặc biệt mặc quần áo bao gồm một polyacrylate mặc quần áo nhiều lớp với dung dịch Lactat Ringer có thể được coi như là một sửa đổi của kỹ thuật ướt, ẩm ướt ' | 126 Chapter 9 Debridement Wet-to-moist dressings may be used on leg ulcers when one prefers to avoid soaking of certain body regions such as the foot. Unnecessary immersion of the feet may lead to maceration which is not desirable especially for diabetic patients. A special form of dressing consisting of a multilayered polyacrylate dressing with Ringer s lactate solution may be regarded as a modification of the wet-to-moist technique. The presence of Ringer s lactate creates a moist environment with softening and loosening of slough. This type of dressing is discussed in detail in Chap. 8. There is a clear distinction between soaking the ulcer region in water as described above and repeated washing or the repeated placing of a single-layered damp cloth on the ulcer enabling the ulcer to dry out. Soaking or covering the ulcer with saturated cloth preventing the ulcer from drying out results in a debriding effect as described above. It is intended to soften and loosen slough or dry necrotic tissue. In contrast to soaking repeated wetting achieves the opposite effect as described below. When the added water either by washing or repeatedly applying a damp cloth or a damp gauze evaporates the treated area gradually dries out. This is intended for secreting ulcers. Repeated wetting is not considered to be a debridement technique - it is just a cleansing method that can also be used for drying out any other types of inflamed secreting areas of the skin. This mode of treatment is also discussed in Chap. 20. A modification of the latter method is repeated wetting when the gauze is left to dry so as to adhere to the ulcer bed as in the wet-to-dry technique described below. 9.4.2.3 Wet-to-Dry Technique The wet-to-dry technique is a modification of the repeated wetting technique in which the gauze dressing is left to adhere to the ulcer surface. It is a useful method in cases where necrotic tissue is accompanied by relatively moderate amounts of exudate. In this procedure a .