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摘要


大面積燒傷是全身性的疾病,除了充分了解傷口癒合機轉外,正確燒傷深度判斷和面積評估是大面積燒傷治療重要的基本步驟。由於治療方法的快速進步,包括適當體液復甦術、早期傷口切除、早期植皮、有效的熱量補充和積極的敗血症治療等,已大大提升了大面積燒傷的存活率。然而,對大面積燒傷的存活者而言,疤痕肥厚攣縮僵硬導致關節活動受限制是後續臨床的挑戰性問題。總結,大面積燒傷治療與復健過程漫長且多面向,需要一個完整的治療計畫,及一個包括醫師、護理人員、社工、復健師和心理師的健全團隊,透過彼此間充分的溝通與相互的支持,完成協助病人重返社會為最終治療目的。

並列摘要


Major burn injuries constitute a systemic disease. In addition to completely understanding the mechanisms of wound healing, precise burn depth and area assessment is critical to the successful management of burn injuries. The recent advancements in post-burn fluid resuscitation, tangential burn excision and grafting, effective enteral tube feeding, and aggressive sepsis treatment have helped greatly increase the survival rates for major burn injuries. However, the restricted joint motion that results from hypertrophic scar contracture remains the main challenge facing burn survivors. In conclusion, as the course of the treatment and rehabilitation is prolonged and multifaceted, a complete treatment plan is always necessary in addition to teamwork among physicians, nurses, social workers, physical therapists, and psychologists. Finally, social return is the final goal of treatment and may be achieved only through mutual support and understanding among the members of the burn treatment and rehabilitation team.

參考文獻


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Keaney, T. C., Tanzi, E., & Alster, T. (2016). Comparison of 532 nm potassium titanyl phosphate laser and 595 nm pulsed dye laser in the treatment of erythematous surgical scars: A randomized, controlled, open-label study. Dermatologic Surgery, 42(1), 70–76. doi:10.1097/DSS.0000000000000582
Klotz, T., Kurmis, R., Munn, Z., Heath, K., & Greenwood, J. E. (2015). The effectiveness of moisturizers in the management of burn scars following burn injury: A systematic review. JBI Database of Systematic Reviews and Implementation Reports, 13(10), 291–315. doi:10.11124/jbisrir-2015-2450

被引用紀錄


黃弋俽、黃敏勤、柯薰貴(2024)。一位嚴重燒燙傷病人調整身心回歸生活的質性分析高雄護理雜誌41(1),20-32。https://doi.org/10.6692/KJN.202404_41(1).0002
方昭敏、李易靜、張瓈方(2017)。照護一位塵爆燒傷病人之護理經驗源遠護理11(1),52-59。https://doi.org/10.6530/YYN/2017.4.1
呂欣怡、謝淑貞、許芳維、魏玉芳、闞秋萍、李佳晏、戴念梓(2019)。提升整形外科手術護理師微粒植皮手術操作完整率源遠護理13(3),47-57。https://doi.org/10.6530/YYN.201911_13(3).0007
王虹雯、吳珮菁(2023)。照護一位燒燙傷導致右手肘下截肢病人之加護經驗領導護理24(4),131-146。https://doi.org/10.29494/LN.202312_24(4).0010
蔡淑如、康芳瑜(2019)。運用薄井坦子全人照護模式照護一位燒燙傷病患之護理經驗領導護理20(4),68-81。https://doi.org/10.29494/LN.201912_20(4).0006

延伸閱讀


  • 吳其炘、李明濱(2004)。燒傷之心身醫學觀北市醫學雜誌1(3),252-260。https://doi.org/10.6200/TCMJ.2004.1.3.02
  • 簡守信(1989)。燒傷及其處理慈濟醫學雜誌1(1),40-44。https://doi.org/10.6440/TZUCMJ.198905.0040
  • 王健興(2015)。燒傷處置人醫心傳-慈濟醫療人文月刊(139),76-79。https://www.airitilibrary.com/Article/Detail?DocID=P20141210001-201507-201508070004-201508070004-76-79
  • 陳立育、陳仲達、陳昱宏(2023)。輕微燒傷在基層醫療之處置家庭醫學與基層醫療38(3),72-79。https://www.airitilibrary.com/Article/Detail?DocID=P20090727001-N202303280016-00001
  • 謝玉琇(2016)。The Nutrition Care of Severe Burn Patients護理雜誌63(1),22-29。https://doi.org/10.6224/JN.63.1.22

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