Nursing observation and practice of complex wound of large area connectivity subcutaneous abscess
大面积连通性皮下脓肿复杂伤口的护理观察与实践

摘要

通过对一例大面积连通性皮下脓肿的复杂伤口处置，评估并观察护理过程中伤口的局部及患者的全身整体状况，应用伤口处理技巧，衔接医护患沟通，多学科联合，为该类型伤口处置总结并积累护理实践经验。此案例在门诊护理进程中，涉及黑痂的可祛除性思考，伤口创面床准备后是否行植皮术、负压吸引术等的相关治疗，血糖监测、营养评价；患者意愿、选择及参与性等多因素问题；并于伤口护理中后期，对存在的伤口窦道采用B超影像学引导下穿刺行引流管置入术等学科联合的治疗及护理措施的实践过程。患者经三个多月的治疗与护理，脓肿消退，伤口面积分别由 7*8cm、3.5*2cm、2.5*4cm；窦道8.9cm（2022.8.3）三处至全皮肤层完整，达到伤口临床愈合。

Abstract

Through the complex wound treatment of a large area of connectivity subcutaneous abscess, the local wound and the overall condition of the patient in the nursing process were evaluated and observed, and the wound management skills were applied to connect the communication between the patient and the doctor, and the multidisciplinary combination was used to summarize and accumulate nursing practice experience for the treatment of this type of wound. In the process of outpatient nursing, this case involves the consideration of the removal of black scab, the relevant treatment such as skin grafting and negative pressure aspiration after the preparation of wound bed, blood glucose monitoring, and nutritional evaluation. Multiple factors such as patient willingness, choice and participation; In the middle and late stage of wound nursing, the combined treatment and nursing measures such as B-ultrasound imaging guided puncture and drainage tube insertion were adopted for the existing wound sinus. After more than three months of treatment and nursing, the abscess subsided, and the wound area was 7*8cm, 3.5*2cm, 2.5*4cm, respectively. The sinus was 8.9cm (2022.8.3) in three places to the whole skin layer, and clinical healing of the wound was achieved.