4 狗與人皮膚結構差異Canine epidermis has a turnover rate of 20 days compared to humans which occurs approximately every 28 days.The epidermis of a dog is 3-5 cells thick however in humans it is at least cells thick.4
5 傷口分類 Classification： Causation Skin depth Acute vs. Chronic Extent of infection
6 傷口分類：成因AbrasionsSurface of the dog’s skin is scraped, scratched, and usually some bruising is present.Area of abrasion will most likely have hair loss present.May have some bleeding and oozing at the wounded area.LacerationsArea of skin is broken or cut open and bleeding.Area of cut can appear clean and well-defined or jagged and dirty.Obvious pain around wounded area.Bleeding at site of laceration.Puncture/Bite woundsSmall holes will appear at wound site, as well as bruising.Bleeding from areas of puncture.Pain associated with wounded area.Redness and swelling may also be present at site of puncture/bite wounds.6
14 表層傷口癒合 引發發炎 (inflammatory repair)，為再生性機制，表皮會長出和原來一樣的組織細胞，所以不會留下疤痕。 Superficial Skin LesionsPressure (shearing & friction)First degree burnsContusionsStimulates an inflammatory repair processSoft tissues heal themselves over timeInterventions can hasten process (athletes) prevention of further complication (MO)引發發炎 (inflammatory repair)，為再生性機制，表皮會長出和原來一樣的組織細胞，所以不會留下疤痕。EpidermisDermis
16 Partial Thickness Wound Partial-Thickness loss of the dermisAbrasionsSkin tearsStage II pressure ulcersSecond degree burnsFollow ng injury body immediately begins repair processInflammation Epithelializationepithelial cells migrate and replicate via mitoses and traverse the wound.Wound contracture is not a common component.
24 滲出液的功能:創造傷口癒合環境Basic concept is that the presence of exudate will provide an environment that stimulates healingExudate contains:Lysosomal enzymes, WBC’s, Lymphokines, growth factors……..There are clinical studies which have shown that wounds maintained in a moist environment have lower infection rates and heal more quickly
25 Exudate(滲出液) All open wounds produce exudate. Exudate is a combination of the fluid normally found bathing the cells and additional fluid, which leaves the blood supply and migrates to the wound site during the inflammatory stage of wound healing.WoundExudateAcuteRich in growth factors and helps the wound to healUsually pale amber in colorChronicHypoxic nature causes changes to wound exudate and can be detrimental to wound healingYellow or green when infected
26 濕式傷口癒合概念在1962年，英國倫敦大學的George D. Winter 博士 ( )於Nature雜誌上發表濕式傷口癒合的概念。研究發現傷口在濕潤的環境下，細胞的游移速度及再生能力增加，傷口復原的速度比在完全乾燥的環境下快一倍以上。以此理論為發展基礎，濕式傷口癒合敷料逐漸取代傳統敷料，濕式傷口照護成為傷口護理的趨勢。傳統敷料紗布濕式敷料親水性敷料泡棉敷料1. 增加動畫, 配合口說順序26