1例回肠造口术后严重粪水性皮炎并皮肤黏膜分离的护理

Nursing of one case of severe fecal dermatitis complicated with skin and mucosa separation after ileostomy

总结1例回肠造口术后出现严重皮肤黏膜分离的护理经验。护理要点:运用湿性愈合理念处理皮肤黏膜分离,正确选择敷料促进伤口愈合,减少瘢痕的形成;合理选用凸面底盘及造口附件产品,压低造口周围皮肤,促使排泄口在理想高度;及时有效的沟通与医护配合,选择合理的营养途径,准确有效的机械清创,加速了伤口的愈合;加强个性化评估和指导,出院后做好延续性护理,提高患者的生活质量。经过44 d的治疗与护理,患者造口周围皮肤恢复效果满意,为顺利进行回肠造口还纳奠定了良好的基础。

To summarize the nursing experience of 1 case of severe skin and mucosa separation after ileostomy.Nursing key points:the concept of wet healing was applied to deal with the skin and mucosa separation,and the correct dressing was selected to promote wound healing and reduce the formation of scars;convex chassis and stoma accessories were rationally chose,and the skin around the stoma was depressed to promote the excretory outlet at the ideal height;timely and effective communicate and cooperate with medical care,choosing reasonable nutritional channels,accurate and effective mechanical debridement can accelerate wound healing;personalized assessment and guidance was strengthened,and continue nursing after discharge was done to improve the quality of life of patients.After 44 d of treatment and nursing,the patient's skin around the stoma recovered satisfactorily,laying a good foundation for smooth ileostomy.