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What is stomach acid? Foods that reduce stomach acid

Beware if your stomach starts to boil after every meal!
What is stomach acid? Our stomach secretes a special acid component to digest the food we eat, making food digestible in the intestines. However, if the acid content increases, gastritis and ulcers occur in the stomach. Although the acid content decreases, indigestion problems begin this time. If the acid escapes from the esophagus, this time the disease begins to be seen, such as reflux. If you have an excess of stomach acid, stomach problems such as burning, pain will occur. In the meantime, the pH of the gastric acid is in the range of 1.0 to 3.5. If you go over this range or fall below some of the problems will begin to open the door. Inflammation of the stomach, duodenal ulcer: pain that begins shortly after eating. Gastric ulcer: Pain that starts 2-3 hours after eating treatment. If your stomach acid is low, you will start to experience complaints such as bloating, indigestion and constipation. How is stomach acid removed? If you think you have an excess of acid in your stomach, the first thing you should do is consult a doctor and use the medications he recommends. The doctor's anti-acid and acid-absorbing drugs in the stomach will give you a lot of comfort. In addition, some of the things you need to pay attention to to control the stomach acid are as follows:

- Start a meal with raw salad or fresh fruit.
- Food should be chewed thoroughly and eat slowly.
- You should leave the table before filling the stomach completely.
- Do not drink too much water during and after meals.
- The temperature of our food is also important, so the food should be neither too hot nor too cold.
- You should rest for about 1 hour after a meal.

Foods that reduce stomach acid All vegetables rich in fiber will help your stomach. These vegetables will also create a feeling of lasting satiety and help you lose weight. Vegetables rich in fiber can be listed as broccoli, eggplant, lettuce, turnip, cabbage and artichoke. In addition, lean protein intake balances stomach acid. But if you eat fatty veal in the presence of protein, the situation will reverse and your stomach acid will increase this time. For protein, fish and cereals such as lentils, dried beans will be more healthy to turn to. grapefruit, oranges, mandarins such as fruits will harm you, apples, raspberries, blackberries, kiwi, watermelon will relax your stomach as well.
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Wound Care

Pressure sores occur as a result of circulatory disorders in soft tissues, usually on the bone protrusions, which are exposed to pressure in the body. In the old nomenclature, these wounds were described as decubitis ulcer. Decubitus ulcer and bed sores, which are derived from the Latin word decumbere, meaning bedtime, are also used synonymously with pressure sores, but pressure sores are not sufficient only for inpatients but also for wheelchair users. Since pressure is the most important factor in the development of these wounds, the term pressure sores is considered the most accurate nomenclature.

Although pressure sores appear to be a problem for chronic patients, the onset of ulcers often coincides with the acute phase of the disease. This is because attention is directed to the patient's primary problem during acute illness and the risk of developing ulcers is often ignored. 63% of ulcers develop while the patient is still in hospital. It has been reported that 41% of cardiovascular diseases, 27% of acute neurological disorders and 15% of orthopedic injuries develop compression pressure.

Pressure is the most important factor in the development of pressure sores. Soft tissues, especially under the pressure of the bone protrusions due to the compression of the tissue can not be fed and continuous pressure is not prevented ulcers and tissue death develops. In paralyzed patients, the defect in pain and loss of movement leads to the inability to detect the pain associated with the pressure and to eliminate this pressure due to loss of motion even if it is detected.
External factors such as moisture, infection, friction, and shear forces generated during transport of the patient, as well as patient-related factors such as general condition disorder, nutritional problems, advanced age, diabetes and edema, facilitate the development of pressure sores by reducing tissue resistance to pressure.

Classification of Pressure Wounds

In pressure sores, there are 5 stages according to the most commonly used classification, although different classifications are used for the depth of the wound.

Stage 1: Skin redness and edema. If pressure is removed and well maintained, the damage is reversible and recovery is often complete.

Stage 2: There is advanced superficial tissue death into subcutaneous tissue. Non-surgical treatments can improve.

Stage 3: There is full-thickness tissue death in the skin. The damage was reduced to subcutaneous tissue. If secondary infection is added, the wound becomes challenging. Surgical intervention is required for large lesions.

Stage 4: The damage includes the bone tissue and the bone descends to the protrusion. Treatment is surgery.

Stage 5: The lesion has spread to bone tissue, joints and body cavities. Bone infection, pathological fractures, joint dislocations, internal organs may become mouth, bacteria may occur in the circulation. According to the spread of the damage, both are always serious cases. Treatment is surgery.

This classification may not always be clinically observed. Often the damage to the pressure wound is cone-shaped. The top of the cone is in the skin and the base is between deep tissues.

Occasionally, a small lesion on the skin may develop a 4th and 5th stage pressure sores.

PREVENTION OF PRESSURE WOUNDS

The precautions to be taken to prevent pressure sores are easier and more economical than the treatment of pressure sores.

The first step in the prevention of pressure sores is education. The patient, family, hospital staff should be informed about the causes and consequences of the wound. The most effective method to prevent these wounds is to change position frequently and to provide movement to the patient as quickly as possible. These patients should be changed positions at intervals of at least 1-2 hours.

People in wheelchairs should raise themselves with their hands every 1-2 hours to ensure that these areas are blooded.

Skin and bed care is very important. The skin should be wiped with soapy water every day and dried so that no moisture remains. Massage should be applied to increase blood circulation and durability of the skin. Bed linen should be clean and dry. The bed and linen under the patient should not be folded.

Urine and cleaning after defecation is very important for bedridden.

Anemia, protein deficiency, vitamin deficiencies, improper dressings and splints, which may cause pressure sores to open, should be eliminated.

Muscle and joint stiffness in patients with stroke should be tackled. Although many beds, wheelchairs and cushions have been developed to prevent the formation of wounds, a device that prevents all of the pressure sores has not been produced yet.

Treatment

Non-Surgical Treatment: If pressure sores are opened, necessary precautions should be taken before they become difficult. In stages 1 and 2, if the pressure is removed and a good care is taken, the healing is achieved automatically. If the pressure persists, the wound deepens and becomes difficult.

Many creams are used in wound care. Despite the rapid progress in wound care in recent years, topical agents are being used in many places that can delay wound healing and damage tissues. The ideal solution for wound cleaning is saline which will not harm the tissue. It is now known that betadine (batikon) solution damages living organisms as well as damaging microorganisms that are the source of infection. Today, newly produced antiseptics are replacing betadine.

Although superficially used antibiotics are still controversial, they develop resistance to antibiotics in bacteria in a short time. Antibiotics given systemically cannot reach the wound sites due to the barrier formed in these wounds. Systemic antibiotics should be given against secondary infections.

Although the bacterial flora changes frequently in these wounds, bacterial culture should be taken by taking samples from the wound in terms of nosocomial infection, and treatment related to urinary bacteria should be shaped.

Many synthetic and semi-synthetic materials have been developed in wound care in recent years. With appropriate patient and wound selection, these wound care materials accelerate the treatment process and reduce the total cost. Wound care products prevent fluid, electrolyte and protein loss from the body and are effective against colonization of bacteria.
There are also various agents that accelerate wound healing. Hydrotherapy, hyperbaric oxygen, ultrasound, electric currents, some topically used pomades are useful in superficial wounds where skin supplements are not lost.

After removal of the dead tissue in deep wounds where the skin appendages disappear, all wounds can be closed by epithelization from the edges with good topical care. The scar tissue, however, lacks skin patches. It may cause continuous pressure sores. Large scars that heal with scar tissue may develop malignant skin tumors in later stages.

Surgical Treatment: 3.4. In the 5th and 5th stages, surgical method is used to treat pressure sores. If the patient's blood values ​​are low in the preoperative period, it should be brought back to normal values ​​that may be operated.

In order to be successful in the treatment of pressure sores, the dead tissue must be removed as soon as possible (surgical debridement of the wound). Although enzymatic debridement methods are used for this, surgical debridement and defect repair should be preferred. The aim of the treatment is to bring pressure-resistant, well-blooded, intact tissues to the wound site. Suitable wound care dressings (hydrocolloid and hydrofiber dressings) are used for this purpose. Since the muscle-skin and fascia-skin flaps used in repair are well-blooded, they provide superiority to other repair methods in the fight against infection at the wound site.

Postoperative Care:

Postoperative care of patients with pressure sores is very important. Patients with flap are usually not laid on the flap for 3 weeks. In this period, starting from the first week, the patient can be given passive movements to the joints according to the surgical characteristics. Prevention of cypasticity after surgery is very important for wound removal. Vacuum drains 5-7. days, the patient is dressed in an elastic corset. Sutures are removed after 10 days. If there is no complication in flap cases, after 3 weeks, patients may begin to lie on the flap. This process starts with 15 minutes per day and can be increased every 5 to 5 minutes. This period should never exceed 2 hours.

Mean duration of hospitalization in patients with pressure injuries is 5-6 weeks. When the surgical costs are considered, it is seen that the precautions to be taken to prevent these wounds are easier and more economical.

VACUUM WOUND TREATMENT (VACUUM ASSISTED WOUND CARE SYSTEM)
What is it: It is a wound healing method with the mechanism of removing the wound liquid from the wound area with the closed-circuit negative pressure system to be applied on the wound. As the healing rate is very advanced compared to classical wound treatment, it is a preferred treatment method in recent years.
How it works: It works by applying continuous or intermittent, controlled subatmospheric pressure to the wound using an electric pump with a special dressing and a connecting tube.
Components:

A special dressing that is usually used sponge. For deeper wounds gray sponge, superficial wounds white sponge is preferred.
Airtight Cover
Collector providing connection between device and dressing
Container where wound fluid drained by Negative Pressure is collected by a closed system
Measure of this pressure that applies negative pressure to the system
Which Wounds Are Suitable

Healing Process Prolonged Open Wounds
Diabetic ulcers
Bed Sores (Pressure Ulcers-Deqübit)
Opened Wounds Due to Circulatory Disorders (Venous Sedge ulcers)
Traumatic Wounds
Unclosed Wounds as a result of surgical procedures
Grafts, flaps
Intraabdominal injuries
Inflammatory wounds with discharge
Wounds That Application Will Not Be Correct:

Unwounded Wounds
The presence of bone inflammation must have received treatment before the start of vacuum treatment
Vascular integrity is at risk.
Wounds with fistula near the breech
What Is The Advantage (advantage) Of Other Wound Treatment Methods.

Reduction of the number of bacteria due to keeping the wound dry
Increased regional blood flow, consequently reduced edema, easier access to active cells in wound healing
Rapid contraction of the wound boundary with narrowing from the edge to the center of the wound Less unwanted scar tissue
Immune return to normal due to effective blood supply to the wound
Shortening of recovery time
Triggering of cell division due to mechanical stress in cells due to variable pressures and increased production of healing tissue
What is the Disadvantage of Other Wound Treatment Methods?

More Costly.
Application should be done by health personnel who require special training.
There are differences in efficiency between the device and sponges depending on the manufacturer.
The device cannot be mobile for a long time due to the need for energy connection.


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What should be done to prevent bed sores?

Deniz Yahcı Bed, who stated that the success of wound treatment is increasing thanks to the simultaneous force of many branches in wound treatment, advised to prevent wounds

Bed sores can become a fearful dream in patients who are bedridden or have limited mobility. Bed wounds can be played by many factors, both related to the patient and the environment.

GREAT DANGER FOR THE ELDERLY IN SUMMER!

Due to the increase in the average age of today due to many chronic diseases such as dementia, Alzheimer, there has been an increase in the rate of bed-dependent patient population, indicating that the rate of bed sores increased parallel to the wound care nurse Deniz Yahci, refers to important points about bed sores.
Deniz Yahcı states that the success of the wound treatment has increased thanks to the strength of many branches at the same time in the field of wound treatment.
IMPORTANT POSITIONING TO THE PATIENT
"One of the important points of bed sores is positioning the patient. Bed sores are more common in patients with elbows, coccyx, heels, backs of the head and right or left regions. These areas where muscle tissue is less are exposed to compression and oxygen free for a long time. Because the tissues cannot feed well, they begin to lose their vitality, and the infections are spreading more rapidly in the dead tissues, and most of the time, a huge wound is opened in 1 night and this is how the problem occurs. needs to be provided.

BED SHEET SPECIAL FOR BED PATIENTS

The position of the patient should be changed to a maximum of 2 hours. Because the patients cannot change their positions and stay in the same position for a long time, bed wounds develop rapidly. In such cases, we can use specially equipped beds, special products to relieve the pressure there, or we can prevent bed sores by positioning the patient at various angles every 2 hours. The angles of these positions may change from time to time. The body parts of the patient that come into contact with the bed and the body parts that come into contact with each other, such as the knees in the patient lying sideways, should be checked frequently for redness. It should be noted that redness that does not persist is the initial stage of pressure ulcer. If the patient is in the supine position or in the sitting position, a pillow must be placed between the knees in the patient lying sideways to remove the pressure on the heels. "

AIR FLOW IN BEDS IMPORTANT
Explaining that many modern pressure-reducing bearings are now available, Deniz Yahcı said, Esk In the past, we do not recommend them with diamond sliced ​​air mattresses. This does not mean that we have an air mattress and there will be no bed sores.
The environment is one of the biggest factors in wound opening.
•Pressure
•Friction
• Tear
•Heat
• Moisture (wet skin)
• Lack of cleanliness
• Maintenance and behavior errors (wrong lying and sitting position)
• Auxiliary materials
•Medicines
pressure sores may occur due to factors.
Stating that one or many combined treatment methods are used in the treatment of bed sores, Deniz Yahcı explains that these methods vary according to the wound and the patient, while Negative pressure, modern wound care products and stem cell treatment are a few of them.



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This is how chronic wound care is done

Plastic, Reconstructive and Aesthetic Surgery Specialist Asst. Assoc. Dr. Ercan in Cihandar Yahc chronic wound care nurse at the Sea announces new treatment methods applied in the world and Turkey.

Chronic wound care and treatment is one of the most important issues that attract attention in the health sector in our country in recent years. Plastic, Reconstructive and Aesthetic Surgery Specialist Asst. Assoc. Dr. Ercan Cihandide wound healing, the person's age, the shape of the wound and the location of the formation of the difference, he noted.
Assist in explaining that they apply new treatment methods in chronic wound care. Associate Professor. Cihandide, high cholesterol, high blood pressure and smoking due to congestion of the arteries, narrowing caused by circulatory disorders, wounds caused by long-term bed-dependent patients, pressure sores and foot wounds as a result of diabetes treatment with the new treatment methods, he said.

Asst. Assoc. Dr. Jihandide, '' First, we investigate the cause of the formation of foot wounds and multidisciplinary approach by starting the business by destroying the source. Later, we follow the wound with modern wound care products used in wound care. Our priority is to close the wound using the patient's own tissues. If not, we activate skin and tissue transplants. Shrink the open wound, free tissue transplants, flaps and skin patches applied from neighboring areas, closing the wound by completing the treatment, '' he said.

New treatment for diabetic foot wound with stem cell and growth factor

Diabetes-related foot wounds in the case of closure of new treatment methods that refer to Asst. Associate Professor. Cihandide and Deniz Yahcı '' Diabetic foot wounds are one of the most common complications of diabetes. Conventional treatment methods such as removal of dead tissues, bypass vascular surgery, and antibiotic treatments for these wounds can often fail. In fact, the cutting of feet and legs can become inevitable. We successfully apply growth factors, one of the new treatment modalities that allow the wound to close and heal quickly. We have applied this treatment method in many patients with diabetic foot wounds and amputation (amputation) decision of many patients without the need for amputation, '' he said.

Stem cell transplantation is applied to some patients indicating that Assist. Associate Professor. Cihandide, '' a large number of differentiated cells in our body is seriously damaged or sickly can not be renewed by natural means. Stem cells are used to create healthy and functional cells instead of these infected or damaged cells. Although it has only been administered to a limited number of patients, successful satisfactory results exist in the treated patients, and the clinical potential of stem cells is being used in the treatment of other diseases. '' He said.


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Treatment of kneecap wounds and cuts

No matter how hard we try to monitor our children and ensure that they are safe, all children of preschool and school age will occasionally have cuts, scratches or abrasions. It is important that parents know when to seek medical help and how to treat small skin wounds.

Injuries that require medical attention include:

• non-stop bleeding wounds;

• very large or very deep wounds;

• sores caused by possibly dirty objects such as nails.

Wound care

Start by applying pressure

Stop the bleeding by applying a hard pressure on the area for five minutes with a clean gauze or normal cloth. If bleeding continues despite pressure, you should consult your pediatrician.

Clean the wound

The wound should be cleaned after the bleeding is under control. Keep the injured area under cold or warm running water for a few minutes to remove small dirt and dust. Avoid abrasive rubbing of open wounds and use iodine, alcohol or other antiseptic solution, which will be uncomfortable for your child. Remember to consult your doctor before giving your child any medication. Aspirin should always be avoided as it will increase bleeding among other reasons.

Apply ointment

After the area is cleaned, apply ointment and cover with a non-stick bandage. Replace the bandage every day or when it becomes dirty or wet. Once the area appears to be healing, the bandage can be removed and the wound left to heal in the open. Contact your doctor if your child's fever rises or if redness or leakage appears in the injured area. These symptoms may indicate an infection, in which case you should consult your doctor.

In the emergency room

Deep wounds on the skin should be treated by a doctor. Usually this is done in the emergency department or emergency care clinic.
What can be done in such a medical intervention in the hospital?

Cleaning

First of all, anesthesia will be applied to the area with a drug injected in local form or by needle. Generally, the wound will then be removed by spraying cold water with a syringe to remove small dirt and dust.

Closing

The doctor will then decide the best way to close the wound. The standard method is to use stitches, staples or medical glue, depending on the location and length of the wound. Staples and stitches are usually removed in one to two weeks.

A newer treatment method that can be used for very large or deep wounds in areas without high levels of skin tension is to use tissue glue. This material is applied to the cleaned wound edges and joins the edges like a Japanese adhesive to the skin. This has the advantages of being fast, without stitches to be removed and leaving no marks on the skin. Unfortunately, tissue adhesive cannot be used in all wounds.

Preventing or limiting scars

• You can minimize scars as follows:

• Keep the wound covered during the initial stages of healing. This will help to accelerate the formation of new skin.

• It is important to keep your child relatively inactive during the recovery period. To reduce the risk of further damage to the wound, make sure to avoid hard spores (especially sports involving contact).

• Make sure your child gets enough food. Abundant vitamins, minerals and trace elements are important during the healing process of wounds.

Don't forget to keep your calm, your child will be calm! Also use the healing power of mother kisses and love on all wounds!


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Wound Care and Dressing

Open Wounds

-Abrazion (abrasion, abrasion)

- Incision

-Avulsion

-Laseration (tearing)

- Penetration

- Crush

- Gunshot injury

Absorbent dressing; is the closure of the wound surface with absorbent, dry material to allow suction from the wound to be absorbed. Soft wraps also provide absorbent dressings.

Wounds by Contamination with Pathogen Microorganisms
Firearm injury; penetrating and penetrating wounds caused by bullet, bullet, bullets and gunpowder.

The incision is the wound opened on the body surface by cutting tools. Surgical wounds of the desired size and width opened in the hospital environment is also called incisional wound. The wound edges are smooth.

Pressure dressing

Wound care (dressing) is a process made with aseptic materials that protect the wound from external factors, remove the secretion from the environment, apply pressure to the bleeding area, facilitate the administration of medications, and maintain the anatomical position of the wounded area.

Crush

TRAUMA
Firearm injury

Penetration

An acute wound is a wound that heals normally in the expected time.

there are no factors that prevent healing (diseases, age, etc.) and healing is continuous.

Dry dressing

INTA. DR. Contact ZEYNEP directly
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Wound Care and Dressing
Protective dressing; is a dressing made by covering the wound surface or the moistening material placed on the wound with waterproof material to protect the wound from the external environment.

Blunt injuries caused by knocking and impacts on the skin surface. Skin integrity is intact. Ecchymosis and edema are seen in the wound area.

Acute wound

contusion

Avulsion is a part of the skin ruptured or separated so that a small part remains attached. The part that is completely broken is called the flap and the part that is separated is called the pedicle. The amount of bleeding is high.

Wounds by Time of Occurrence
Dry dressing; the epidermis is intact and the dressing material is not likely to adhere to the wound.

Pressure dressing; to stop bleeding, to reduce edema, to close the dead cavity of the wound surface of the wound with pressure is to close the material.

The pressure is applied equally throughout the wound.

If pressure dressing is to be applied to the extremity, the dressing starts from the distal and proximal to the wound.

A chronic wound is a wound that does not close within three months.

The wound repeats continuously. There is a local or systemic factor that prevents wound healing. Example: Bed sores.

For physical and chemical reasons, skin, muscle, bone, vessel, nerve, etc. deterioration of the integrity of structures, destruction, the temporary or complete loss of physiological properties of tissue is called trauma.

Chronic wound

Blast effect injury

Absorbent dressing

Clean wound

Laceration is the deterioration of skin integrity due to the force of blunt and crushing objects (traffic accidents, bullets or bomb fragments). Irregularity and crushing may occur at the wound edges due to ruptures.

Wet dressing is applied if a wound medication or antiseptic is to be applied to the wound.

The wet dressing must be changed at least every two hours.

A clean wound is a non-pathogenic wound.

No tissue loss,

No infection,

The wound edges are joined,

Wounds that develop minimal scar tissue are clean wounds.

Abrasion occurs when the skin rubs against a hard and uneven surface. Damage to the epidermis and dermis. Capillary bleeding, pain and redness are seen in the injured area.

Infected wound

Infected wound is a wound containing pathogenic microorganisms.

Yarada; Redness, pain, discharge, bad smell etc. Symptoms of infection are seen.

Delayed wounds (more than 6 hours),

Wounds with uneven edges,

Wounds separated by seams,

Very dirty and deep sores,

Firearm wounds,

Wounds caused by biting and insertion

Protective dressing

Closed wounds

-Kontüzyo The (crushed)

-Blast effect injury

Avulsion

Wounds;

to view
cause of occurrence
pathogen microorganisms are classified in different ways according to the contamination status.
Laceration (tearing)

Crush, debris, work accident, traffic accident and so on. as a result of the events due to crushed skin and subcutaneous tissue occurs with the breakdown. Bleeding, tissue and nerve damage may occur due to injury. perforation of hollow organs; organ rupture may be seen in solid organs.

Wounds by Skin Integrity
Incision

Penetration, deep tissue and organs lead, knife, nail, screwdriver, skewers and so on. puncture wounds. The width of the wound entry is small and the depth is high. It is often difficult to detect deep damage. All muscles and blood vessels, as well as the size of the piercing device, may be torn or injured.


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Wound care, suture, tetanus, rabies vaccination, dressing course notes

After evaluation of the airway, respiration and circulation and stabilization of the patient, wound evaluation is performed.

Small objects can cause superficial injuries, while bite or crush injuries can cause greater tissue damage.

We look at the appearance of the wound and get clues about its closure. Irregular-looking wounds can be difficult to close and may take time to heal.

If we delay wound care, the risk of infection increases. If there is more than 12 hours delay, wound closure techniques change.

Age, physical condition, health status and even occupation of the patient affect wound healing; diabetes, neuropathy, obesity, malnutrition or corticosteroid use may delay wound healing.

The use of aspirin and corticosteroids also affects wound healing.

The patient's work; it affects wound healing if it is a problem in terms of wound care and the stability of the wound site.

Smoking also has negative effects on wound healing.

A history of allergy and all of the above information should be obtained from the patient; this history helps nurses for situations such as wound fixation techniques, wound closure techniques, and giving patient discharge information.

Concomitant injuries such as fracture-dislocation and vascular-nerve injury should be evaluated.

Tendon and ligament injuries and foreign body nerve damage should be evaluated.

Agricultural wounds, such as human bites, such as wounds in the very dirty environment during the injury should be carefully evaluated. The risk of infection is very high.


SPECIAL INJURIES

Abrasion, abscess, avulsion, laceration, penetrating wound and bite are divided into basic groups.

Let's examine them in detail.

abraded

It occurs when you rub your skin on a hard place.

Not only rubbing, but also minor burns. The main event is that the epidermis is damaged and part of the skin is separated and the substrate is vulnerable.

This can cause loss of fluid.

If foreign objects remain on the skin at this time, this may cause scarring. This can be prevented by wound cleaning.

In wound treatment, local anesthesia, antibiotic ointment and non-sticky dressing can be used until scar tissue is formed. Some wounds may be left open.

These wounds should be protected from the sun for 6 months in order to avoid color differences in the newly formed tissue.

Absa

Abscess develops by collecting pus formed under the skin. Treatment of abscess should be cleaned and a loose dressing should be performed. Antibiotics can be used in case of recurrence and fever.

the avulsion

It is a loss of skin where it is not possible to combine the wound edges.

Some avulsions may require tissue grafting. The wound should be drained, cleaned and closed.

Local anesthetics should be used.

contusion

Swelling is a trauma, contusion or crush injury where pain and discoloration are not impaired by tissue integrity.

Cold administration can be used in the treatment of analgesia.

Major injuries should be observed for cellulite or compartment syndrome.

the laceration

Wounds caused by cutting forces.

Bleeding must be stopped and neurovascular function distal to the injured area should be evaluated.

Foreign bodies should be removed and anesthetics should be used if necessary.

The wound suture or suture bands and wound edges are closed by bringing them closer together.

The antibiotic is covered with ointment and non-sticky dressing.

Piercing Wounds

More serious injuries from the surface where the underlying tissue is damaged.

They are usually not sutured since the body is not too large.

The risk of infection is high and the underlying tissue must be evaluated.

Necrotic tissue removal, drain insertion and sterile dressing are the treatment steps.

If the foreign body is not too small, it must be secured until it is safely removed.

The presence of foreign bodies inside can be investigated by radiography.


Bites

They are complicated wounds including contusion, avulsion, laceration and penetrating injuries.

It may be of human or animal origin.

Infection can have complications such as abscess, cellulitis, septicemia, osteomyelitis, tenosynovitis, rabies, tetanus.

The highest risk of infection is in human bites.

Immobilization and antibiotic treatment are important.

In human bites; Neurovascular evaluation, debridement of the devitalized tissue and dressing are very important. Antibiotics should be given within 3 hours, most of which are left open.

In animal bites; infection, tetanus and rabies risk. Patients over 50 years of age, hand injuries, deep injuries, and 24-hour delayed treatment have a higher risk of infection.

Wound cleaning, washing with plenty of soapy water, debridement, closing small wounds are among the treatments.

Antibiotic treatment, suturing of the wound is discussed according to the condition of the wound.

High-risk wounds should not be sutured, as they carry a risk of infection. Tetanus and rabies vaccine should be given to all patients.

Wound Preparation

High-pressure irrigation with debridement is the most recommended anti-infection preparation.

Wash heavily contaminated wounds for at least five minutes.

Piercing wounds are more pressureful and effective irrigation wounds.

The removed object must be completely removed.

Eyebrows should not be shaved, but eyebrows should be used as a mark for wound closure.

Other areas can be cut instead of shaving.

In wound cleaning 10% solution of povidone 1% concentration can be used. However, no solution is used.

Hydrogen peroxide and alcohol are not used in open wounds.


LOCAL ANESTHESIA

Local anesthesia is used to relieve pain during wound cleaning and closure.

Lidocaine is the most widely used, because of its long-acting effect.

Epinephrine is frequently added to prolong the duration of local anesthesia to provide hemostasis and to slow down the absorption of anesthetic.

Lidocaine with epinephrine is not used in areas with artery feeding.

If sodium bicarbonate is added to the anesthetics (8.4%), the pain associated with infiltration is further reduced.

Tropical anesthetics are ideal for children.

It can be applied by waiting 2-3 ml of anesthetic solution impregnated with cotton for 20 minutes in the wound and can eliminate the need for needles.

Since they contain an epinephrine component, they are not used in areas with artery feeding.

Another method is to numb the area with fewer anesthetics. This tourniquet is placed proximal to the tissue, then the analgesic material is injected distally into the wound. Wound repair is performed, the tourniquet is not opened during this period after the repair is opened so that the anesthetic substance is slowly absorbed.

Wound Closure

Primary; The edges of the wound are zoomed in, secondary; wounds that are left open due to non-converging or non-converging wound edges, tertiary; the wound is left open for edema or for reasons that need to remain open, then the wound edges are joined (after 5-10 days).

Wounds that cannot be closed with these methods require skin grafting.

Adhesive tape, stapler, wound adhesive can be used in primary closure.

Sticky tape

This method can be used for small wounds, to accelerate recovery after suture removal in elderly patients, and after some sutures can also be closed with these bands.

The adhesive tape remains in the wound until it falls off by itself.

sutures

It is a method used to connect the wound edges and prevent infection and scar formation.

There are types that are natural (absorbed) or synthetic (need to be taken).

After suturing a fine antibiotic ointment is applied and the wound is closed.

When do we get it back?

Eyelids 3-5 days,

eyebrows 4-5 days,

ear 4-6 days,

face and lip 3-5 days,

Hand foot body 7-10 days,

Arm and leg 10-14 days,

Joints should be taken after 14 days.


Stapler

It is a fast closing method used in scalp, trunk and extremities.

It protects better from infection, but is not as firm as the sutures and has more scars.

Stapler is preferred where scarring is less visible.

Stap wires remain in place for 7-10 days. Special remover is required for removal.

Dermabond

It is a tropical skin glue and the newest method.

It is not used in tight skin areas.

It is applied in separate layers in the form of zigzag and dries in 2.5 minutes.

No liquid or ointment is applied to the wound.

It gets up in 5-10 days.

Wound Dressing

The goal is to create a clean wound environment with balanced moisture.

Modern dressings aim to keep the wound wet, clean it and keep it away from bacteria.

A thin layer of antibiotic ointment can be used.

Wounds with a fluid flow of more than 50 ml per day or wounds containing liquids that will damage the skin are dressed by means of so-called wound pouch system to ensure that liquid is removed from the wound.

Tetenosis Prophylaxis

Tetenosis is a systemic infection caused by Clostiridum tetanus, a gram-positive, spore-forming, anaerobic bacillus.

Once activated, Basil is resistant to everything, including sterilization.

The incubation period may be from 2 days to 2 weeks or more.

This bacillus can be found anywhere in the soil, algae, animal and human faeces.

Spores can contaminate a wound and remain silent for years.

If tetany enters the circulatory system, it binds to CNS cells and can depress the respiratory center in the medulla.

Symptoms include; local joint stiffness, mild trismus or inability to open the jaw.

In severe cases; severe trismus, low back pain, penis pain, tachycardia, HT, dysrhythmias, hyperpyrexia, opistotonos, and seizures may develop.

It should be noted that most unvaccinated patients are over 50 years of age.

Tetanus should be considered in all patients.

The vaccine should be administered within 72 hours.

Rabies Prophylaxis

May occur by animal bite.

It is the result of a neurotoxic virus found in the saliva of some mammals.

The incubation period is 4-8 weeks.

If the virus is removed, it reaches the CNS from the peripheral nerves and fatal encephalomyelitis occurs.

Carnivore wild animals are always considered rabid.

Animals should be observed for 10 days, if possible, if rabies symptoms are vaccinated.

Vaccination is considered if the animal is missing.

Vaccination can be waited for 10 days according to the condition of the region and the frequency of rabies in animals. If the possibilities do not allow this, vaccination should be started.


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