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بخیه.ppt
1.
بخيه آموزش خدا بنام
2.
كال اين پايان
از پس داريم انتظار شما از ما گرامي دانشجوي س دهيد انجام و بدانيد بدرستي را زير موارد بتوانيد : 1 - زخمها بندي طبقه 2 - زخم با دربرخورد الزم اوليه اقدامات 3 - زدن بخيه براي نياز مورد وسايل با آشنايي 4 - كاركردن استريل نحوه 5 - آن پوشاندن و زخم صحيح شستشوي نحوه 6 - محل كردن بيحس نحوه 7 - زمان حداقل در خونريزي كردن متوقف 8 - زدن بخيه عوارض 9 - بخيه نخهاي برداشتن زمان
3.
زخم بندي طبقه الف : عمدي عمدي
غير ب : باز بسته
4.
زخم انواع 1 - شده كوفته Contusion : شودمي
ايجاد سنگين جسم يك با عضو برخورد علت به . ،دارد وجود وادم درد ،است شده تخريب نرم نسوج ،است بسته زخم اندشده پاره خوني عروق . 2 - ،شده بريده Incision : شودمي ايجاد برنده وسيله يك علت به . ،است باز زخم عروق ،دارد وجود درد ،است شده تخريب نرم نسوج اندشده پاره خوني . 3 - ،شده خراشيده Abrasion : درماتولوژيك عمدي روشهاي انجام يا و پوست سطح مالش علت به شودمي ايجاد . است شده آسيب دچار پوست فقط زيرا ،است دردناك و باز زخم .
5.
4 - ،شده سوراخ Puncture : پوس زيرين
هاياليه به و شودمي ايجاد تيز وسيله يك علت به ت كندمي نفوذ . باشد عمدي غير يا عمدي است ممكن ،است باز زخم . 5 - ،شده دريده Laceration : شود مي ايجاد حادثه يك علت به . ايجاد خطر ،مختلف زخم عمق ،نامنظم آن هايلبه ،است باز زخم است زياد عفونت 6 - ،تميز زخم Clean : شودمي ايجاد جراحي اعمال علت به . ندارد وجود زابيماري عامل گونههيچ ،است باز زخم .
6.
7 - تميز زخم - ،آلوده Clean contaminated : شودمي
ايجاد ويژه جراحي اعمال علت به . كه جراحي اعمال مانند ،است زياد عفونت ايجاد خطر ،است باز زخم و اوروژنيتال ،گوارش ،تنفس دستگاه روي ... شودمي انجام . 8 - ،آلوده زخم contaminated : شودمي ايجاد حادثه يك علت به . است باز زخم . است زياد عفونت ايجاد خطر بوده ملتهب نسوج . 9 - ،عفوني زخم Infected : شودمي عفوني زخم بيماريزا عوامل وجود علت به . برشهاي يا ،ضربه از حاصل زخمهاي يا ،قديمي زخم يك ،است باز زخم است شده ايجاد آلوده فضاي دريك كه جراحي .
7.
برحسب زخم انواع
بندي طبقه : خونريزي شدت خونريزي منشاء زخم وسعت عفونت كزاز به ابتال استعداد ميزان زخم كننده ايجاد عامل زخم ايجاد زمان
8.
Wound Assessment Examination Prep Drape Analgesia Debridment Suturing Dressing Fallow up
9.
كزاز سن باالي 7 سال زير 7 سال پيشگير سابقه ي 3 بيشت يا
بار ر از كمتر 3 بار نامشخص زخم ابتالء استعداد عدم يا استعداد
10.
پيگيري خطر عالئم هشدار بيمار
به آموزش بيمار همكاري جلب
11.
بيشتر خونريزي و
هماتوم تشكيل از جلوگيري هموستازجهت دو به گيرد مي انجام روش : 1 - مستقيم غير Elevation باالتر سطحي به مجروح عضو بردن باال يا از قلب سطح , Vasoconstriction از استفاده با مدت به فشاري پانسمان 20 دقيقه , تورنيكه بستن نفرين اپي حاوي ومحلولهاي 2 - مستقيم شده قطع الكتروكوترعروق و ليگاتور
12.
دبريدمان بافت بريدن و
زخم از آلوده شديدا يا مرده بافتهاي حذف نا هاي بيستوري تيغ از استفاده با هموار
13.
بخيه نخهاي انواع جذب
قابل نخهاي ( : Absorbable ) ساده گوت كات (Plain cat gut) كروميك گوت كات گليكوليك پلي اسيد (Dexon) گالكتين پلي 910 (Vicryl) Polydioxanone (PDS)
14.
جذب غيرقابل نخهاي (
: Non absorbable ) ابريشم ( Silk ) پنبه ( Cotton ) استر پلي داكرون : Mersilene- Polydek Ti, Cron- Ethibond نايلون پروپيلن پلي زنگ ضد فوالد
15.
سوزنها شوندمي بنديطبقه گوناگون
انواع به زير موارد براساس بخيه سوزنهاي : سوزن ته سوراخ : 1 - دارسوراخ سوزن 2 - سوراخ بدون سوزن ( سرخود نخ ) 3 - شل سرخود نخ سوزن شكل : 1 - مستقيم 2 - خميده 8/3 دايره 3 - دايره نيم خميده 4 - خميده 8/5 دايره
16.
مقطع سطح و
نوك : 1 - شونده باريك بتدريج سوزن ( Taper needles ) 2 - برنده سوزنهاي ( Cutting ) 3 - معكوس برنده ( Reverse cutting ) 4 - تيز نوك سيمي سوزن ( Round bodied ) اندازه : ت سوزن انتهاي مستقيم فاصله خميده سوزنهاي در ا شودمي محسوب اندازه ،آن نوك .
17.
3 - شامل بخيه ست : سيني گير
سوزن بيستوري دسته قيچي شستشو پنس پياله گاز ميانباز
18.
نياز مورد سايز
با بيستوري بتادين نرمال سالين سرم ليدوكائين 1 % يا 2 % مناسب سايز با استريل دستكش سرنگ 5 سي سي
19.
بخيه انواع Interrupted: Separate
vertical Mattress Horizontal Mattress 8 form Continuous: Running. C Subcuticular
20.
يعني كردن كار
استريل نحوه : 1 - استريل روش به بخيه ست كردن باز 2 - استريل روش به نياز مورد وسايل كردن باز 3 - استريل روش به دستكش پوشيدن زخم صحيح شستشوي : Drape و Prep زخم محل كردن حس بي نحوه : ليدوكائين از استفاده با 1 % يا 2 % زير تزريق روش به مستقي تزريق يا زخم وسط و زخم انتهاي دو از جلدي م زخم داخل به دارو
21.
بخيه برداشتن زمان بخيه
برداشتن زمان ( روز ) محل 3 4 تا 5 7 7 تا 10 10 تا 12 12 تا 16 پلك گردن و صورت سر پوست و گوش تنه دستها و فوقاني اندام پاها و تحتاني اندام
22.
زخم به مربوط
خطر عالئم مداوم درد انگشتان در سوزش احساس يا كرختي تب لرز زخم از خونريزي زخم از ترشح خروج پانسمان از بد بوي استشمام زخم اطراف سرخي
23.
بخيه برداشتن نحوه 1 - كنيد
پاك الكل با را محل . 2 - بلند آرامي به و گرفته پنس با را گره كنيد . 3 - محلي از درست سمت يك در را بخيه نخ تي يا قيچي شودبا مي پوست وارد كه غ كنيد قطع بيستوري . ديگر سوراخ از تا بكشيد پنس با را نخ بيايد بيرون .
24.
پايان پايان
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