新生儿红斑狼疮合并严重先天性皮肤缺损1例的护理

总结1例新生儿红斑狼疮合并严重先天性皮肤缺损患儿的护理。护理重点为加强创口护理,控制创面的渗液以及感染,加速创面的愈合;做好保护措施,防止皮肤再损伤;合理使用静脉留置针,延长留置针的留置时间;重视全身支持治疗,密切观察病情变化。经过56d护理,患儿痊愈出院。     

1例重度烧伤并发葡萄球菌性猩红热患儿的护理

总结1例重烧伤合并葡萄球菌性猩红热患儿的护理.采取以下护理措施:切实有效的心理护理,严格的床单位环境管理及保护性措施,重视皮疹创面、烧伤创面的护理和正确给药,做好静脉保护和穿刺后护理,患儿痊愈出院.     

新生儿烧伤22例原因分析及护理对策

分析22例新生儿烧伤原因并总结护理对策。烧伤原因主要与其照顾者缺乏新生儿照顾经验及防范意识有关,护理对策包括加强照顾者的养育指导与相关科室护士培训,有效控制与调节新生儿烧伤病房的环境、烧伤休克期合理的补液、保护创面皮肤及脐部清洁消毒、关注疼痛护理并加强营养支持。经治疗与护理,3例患儿创面基本愈合,回当地医院继续换药治疗,19例患儿创面痊愈出院。     

19例葡萄球菌皮肤烫伤样综合征的观察与护理

目的总结葡萄球菌皮肤烫伤样综合征的护理经验。方法通过严格的消毒隔离,有效的皮肤创面保护,加强病情观察与心理护理、饮食护理,促进创面的愈合,减少并发症发生。结果19例葡萄球菌皮肤烫伤样综合征患儿均无并发症发生,无溃疡疤痕形成,10天之内全部治愈出院。结论认真细致的皮肤护理在整个治疗护理过程中起着关键的作用。     

苯丙酮尿症患儿的皮肤护理

总结3例苯丙酮尿症患儿的皮肤护理体会。护理要点包括营养支持、皮肤创面的护理、水肿的护理、保护性静脉穿刺、预防继发性皮肤感染、改良尿片和接尿杯的应用。3例患儿经治疗护理,住院8~10d后营养状况改善、皮肤状况好转出院。     

新生儿先天性皮肤缺损的护理

总结1例先天性皮肤缺损新生儿的护理经验.主要措施为做好缺损处及全身的皮肤护理,行双下肢肉芽创面异体皮植皮术后注意抗感染、营养支持等,患儿创面肉芽组织生长良好,异体皮自行脱落,未再进行第二次植皮手术,于术后48d好转出院.     

幼儿金黄色葡萄球菌性烫伤样皮肤综合征的护理

总结45例幼儿金黄色葡萄球菌性烫伤样皮肤综合征的护理。护理重点为重视环境消毒,做好患儿皮肤创面、眼部及口腔护理,应用激素时注意观察副作用,同时严密观察病情,注意饮食护理、疼痛护理。32例患儿经综合治疗及护理后治愈出院,住院时间5～12d,平均7.8d。     

负压封闭引流技术治疗小儿严重外伤创面的护理

目的 探讨负压封闭引流技术(VSD)治疗小儿严重外伤创面的护理方法.方法 回顾2008年3月～2010年12月应用VSD技术治疗22例因严重外伤所致大面积皮肤软组织缺损的小儿患者临床资料及护理效果.结果 22例患儿创面经VSD技术治疗后,创面良好,无护理并发症.结论 VSD技术在儿童骨科应用护理重点为:术前护理包括评估...     

新生儿先天性皮肤缺损患儿的护理

目的 总结新生儿先天性皮肤缺损的护理经验.方法 对19例先天性皮肤缺损新生儿予以加强新生儿基础护理及消毒隔离,重视较大面积缺损患儿的病情变化及监护,加强缺损皮肤护理,预防感染以及营养支持等综合护理措施.结果 19例患儿均恢复良好.无在院死亡和严重并发症.出院后1年随访18例,皮肤缺损愈合后7例无明显瘢痕,功能恢复良好.11例有不同程度的瘢痕.结论 重视较大面积缺损患儿的监护及病情观察,合理有效的缺损创面护理及严格消毒隔离并加强新生儿基础护理是治愈本病的保证.     

1例车祸致大面积创伤患儿的护理

报道1例因车祸所致多发性损伤合并全身大面积皮肤软组织剥脱伤患儿的护理体会。本例患儿创伤严重,皮肤大片缺损,在积极的抗休克治疗后,先后行7次手术,包括截肢术、腹部探查术、结肠及膀胱造瘘术及4次清创植自体皮术。本例患儿的护理要点包括:积极抗休克护理;做好患儿创面、幻肢疼痛评估及护理;动态评估造瘘口情况,积极抗感染,做好造瘘口护理。患儿经4个月的积极治疗和护理,创面逐渐愈合,且愈合良好,住院期间创面未发生感染,顺利出院。     

A critical review of the inter-relationship between skin vulnerability and urinary incontinence and related nursing intervention

The literature reveals there has been limited critical discussion of the inter-relationship between urinary incontinence, the vulnerability of the skin and the clinical implications. This paper critically re-examines the literature to identify and apply relevant scientific principles and evidence to inform effective intervention. It includes background on the structure, function and disruption to the skin's barrier. The implications for fundamental and largely taken-for-granted nursing practices, such as washing the skin, are examined. The current state of knowledge is analysed, specifying the types of evidence available and its weaknesses, highlighting implications for a research agenda.     

Ultrasonography of nodular and infiltrative lesions of the skin and subcutaneous tissues

Ultrasonography with high-frequency probes was performed on 80 dermatological patients carrying palpable lesions of the skin. The case list included hemo- and lymphangiomas (16 cases), cysts (13 cases), Kaposi sarcomas (9 cases), and panniculitis (20 cases). All lesions underwent open biopsy and histological examination. Ultrasound yielded technically adequate images in 74/80 cases (93%). Angiomas appeared as multiple transonic cavities separated by hyperechoic septa; cysts were usually echo free or weakly echogenic, with smooth outlines. Kaposi sarcomas corresponded to superficial hypoechoic nodules with blurred margins, while panniculitis appeared as a diffuse thickening of the subcutaneous space. When acute inflammation was present, as in most cases of erythema nodosum, a nonhomogeneous hypoechoic pattern was found.     

头颈部皮肤恶性肿瘤的手术切除与修复

目的：总结头颈部皮肤恶性肿瘤手术和修复的临床经验。方法：回顾性分析我科手术治疗的头面部皮肤恶性肿瘤患者125例，术中作冰冻切片监测手术切缘，术后缺损根据患者的情况采用邻近随意皮瓣、直接拉拢、血管化游离皮瓣、带蒂皮瓣、植皮方法修复。结果：本组所有病例均一期修复，甲级愈合。结论：头面部皮肤恶性肿瘤术中作冰冻切片监测手术切缘有助于保证肿瘤的彻底切除。术后缺损的修复方法应根据患者的具体情况而定，其中以邻近随意皮瓣的效果较好。     

Skin ulcers as a complication of short-term use of phenazopyridine in an old man: A case report

IntroductionPhenazopyridine is an azo dye, which exerts local anesthetic or analgesic action on urinary tract mucosa through an unknown mechanism. Besides its common complications including orange discoloration of the urine and gastrointestinal problems, it may have rare side effects like hemolytic anaemia, methemoglobinemia, renal failure, and skin changes. We reported a paraplegic man with skin ulcers on scretom and right foot after about 3 days of phenazopyridine useCase reportA 62-year-old man presented with flesh shaped deep ulcers in lower parts of the body. He declared that at first a bluish discoloration was developed in the lower extremities and scrotum skin after use of eight phenazopyridine tablets (200 mg) and then these lesions turned to blisters and ulcers and they were prurient. The patient underwent sonography and CT-angiography; however, no pathologic findings were found. He just received losartan for many years as past drug history. According to the history, a delayed drug hypersensitivity reaction was suspected and the patient wounds healed after using special type of dressings and antibiotic therapy regarding positive wound cultures.ConclusionPhenazopyridine severe skin changes are hardly reported. We described a case who experienced severe skin reactions and ulcers following phenazopyridine use not related to other complications including renal dysfunction, methemoglobinemia, and hemolytic anemia.     

高频超声对正常成人皮肤厚度测量及声像研究

目的 探讨成人正常皮肤声像图及皮肤(表皮和真皮)厚度差异性.方法 应用14 MHz高频探头对60名正常成人不同部位皮肤声像图观察,并测量皮肤(表皮 真皮层)的厚度.结果 14 MHz高频超声可显示皮肤各层结构.皮肤表皮表现为平滑线状强回声,真皮为低回声带,不同部位皮肤真皮与皮下组织分界清晰或不清晰.表皮和真皮层彩色多普勒血流显像超声未检出血流信号.选择17点部位皮肤观察,其中男女组间12点相同部位皮肤厚度差异具有显著统计学意义.人体不同部位皮肤厚度也存在显著性差异.结论 应用高频超声测量皮肤厚度是可行的方法 .     

变应原检测试验中皮肤点刺法与皮肤压痕法的比较

目的 了解过敏性疾病患者对皮肤点刺试验与皮肤压痕试验的耐受情况与阳性反应.方法 选择过敏性哮喘及过敏性鼻炎及其他过敏性疾病患者共80例,同时进行特异性变应原皮肤点刺与皮肤压痕试验.了解患者对2种方法的不适应感及恐惧程度,并比较2种方法对特异性变应原检测结果的差异.进行统计描述及χ2检验.结果 2种方法对特异性变应原检测阳性率比较无显著差异.大部分患者更愿意接受皮肤压痕试验.结论 2种方法对特异性变应原检测结果基本一致.压痕法使患者痛苦小,恐惧感小,更易接受,临床上可用皮肤压痕试验代替皮肤点刺试验.     

头孢菌素溶解后液量变化对皮试液浓度影响的研究

目的探讨头孢菌素类药物溶解后溶液量的变化，为临床准确配制头孢菌素类药物皮试液，减少假性皮试结果提供参考意见。方法观察研究我院常用的头孢菌素类药物皮试液配制方法，比较配液量及溶解后溶液量变化值及对皮试液浓度的影响。结果大多数头孢菌素类药物存在溶解后液量多于配液量，未考虑溶液量增长所配制的皮试液浓度低于要求浓度（500μg／m1），P〈0.01。结论配头孢菌素类药物皮试液应改进配制方法：即注入溶解液时应考虑减去溶解后液量变化值；在药瓶容量允许的情况下溶解液宜多不宜少，尽可能减少假性皮试结果。     

Determinants of Skin Problems of the Stump in Lower-Limb Amputees

Meulenbelt HE, Geertzen JH, Jonkman MF, Dijkstra PU. Determinants of skin problems of the stump in lower-limb amputees.

Objective

To identify determinants of skin problems in lower-limb amputees.

Design

Survey, using a questionnaire.

Setting

Not applicable.

Participants

Lower-limb amputees (N=2039) who either obtained their prosthesis through the Orthopedische Instrument Makerij (a group of orthopedic workshops in the Netherlands) or were a member of the (Dutch) National Society of Amputees (Landelijke Vereniging van Geamputeerden) were invited to participate. In total, 872 lower-limb amputees agreed to participate.

Intervention

Amputees filled in the questionnaire to assess characteristics of the amputation and prosthesis, level of activity, stump and prosthesis hygiene, and skin problems. Stepwise backward logistic regression was performed to analyze determinants of skin problems.

Main Outcome Measure

Skin problems in the month prior to completing the questionnaire.

Results

A total of 816 questionnaires were received. Eventually 805 questionnaires were suitable for statistical analysis. Protective determinants were (in order of magnitude of association) older age, male sex, and amputation because of peripheral arterial disease and/or diabetes. Provocative determinants were (in order of magnitude of association) use of antibacterial soap, smoking, and washing the stump 4 times a week or more often. In total, 63% of the participants (95% confidence interval, 60%-67%) reported 1 or more skin problems.

Conclusions

The provocative determinants identified in this study—use of antibacterial soap, smoking, and stump washing frequency—have to be studied for their clinical relevance.     

Woman with a hand ulcer

A 20-year-old woman presented to the emergency department for evaluation of a wound to left hand (). She admitted having a history of chronic severe headaches requiring daily use of analgesics. She first noted the ulcer approximately 10 months prior to presentation. Her examination was remarkable for a 10-cm by 8-cm ulceration to the dorsum of her left hand with exposed and necrotic metacarpals. Fibrous exudate was present in the wound-bed, and the ulcer was associated with a foul odor. She was afebrile on presentation with a peripheral white blood cell count of 6.4 x109/L, CRP 1.9 mg/dL, and ESR 15 mm/h.