摘要：The history of wound care and management closely parallels that of military surgery which has laid down the principles and dictated the practices of wound cleansing, debridement and coverage. From a treatment standpoint, there are essentially two types of wounds: those characterized by loss of tissue and those in which no tissue has been lost. In the event of tissue loss it is critical to determine whether vital structures such as bone, tendons, nerves and vessels have been exposed. It is also important to determine the amount of soft tissue contusion and contamination. In any case primary wound healing by early closure either primarily or with the help of grafts or flaps is preferred to secondary healing and wound contraction with subsequent contractures which interfere with range of motion and function. Whether the wound is acute or chronic, essential principles of wound care must be observed in order to avoid wound sepsis and achieve rapid and optimal wound healing. - Tissues must be handled gently. - Caustic solutions capable of sterilizing the skin should never be applied to the wound. It is desirable never to put anything in the wound that cannot be tolerated comfortably in the conjunctival sac. - All devitalized tissues must be debrided either hydrodynamically, chemically, mechanically or surgically. - All dead space must be obliterated. - Exposed vital structures must be covered by well vascularized tissues. An essential part of any wound management protocol is wound dressing. It cannot be too strongly emphasized that a wound dressing may have a profound influence on healing particularly of secondary type healing, a critical feature being the extent to which such dressing restricts the evaporation of water from the wound surface. A review of available dressing materials is reported with emphasis on the newly developed concept of moist environment for optimal healing. a practical guide for dressing selection is also proposed.

摘要：To analyze and evaluate the clinical efficacy of Chinese and Western medical techniques in the treatment of severe diabetic foot ulcers complicated with necrotizing fasciitis of the lower leg and summarize the treatment experience of such patients to identify a new method of limb salvage treatment. A total of 46 patients with severe diabetic foot ulcers and necrotizing fasciitis of the lower leg were treated with such techniques as surgical debridement, bone drilling, open joint fusion, and microskin implantation. Wounds were treated with moisture-exposed burn therapy (a regenerative medical treatment for burns, wounds, and ulcers) and moisture-exposed burn ointment (a traditional Chinese medicine); underlying diseases were also treated effectively. The wound healing time, rate of high amputation, and mortality of these patients were summarized, and the clinical efficacy of such treatments was evaluated. Of the 46 patients enrolled, 38 patients were cured, with a cure rate of 82.61%. The average wound healing time was 130?±?74.37 days. Two patients underwent high amputations, with an amputation rate of 4.35%, and 4 deaths occurred, with a mortality rate of 8.70%. The combination of Chinese and Western medical techniques in the treatment of severe diabetic foot ulcers complicated with necrotizing fasciitis of the lower leg not only effectively saved patients' lives and promoted wound healing but also greatly reduced the rates of high amputation and disability.

摘要：Backgrounds: Burn, a damage and tissue loss caused by heat with a high morbidity and mortality, have a many variation and complex problem that require special management. After a period of shock, there were infections that threaten the burn patients. These hazards aggravate the wound to become wider, and it affects the mortality and the length of stay. That is why to reduce mortality rate and length of stay, we need a proper wound care.Methods:A retrospective descriptive studies was perform on 2b degree burn patients (20-25%) that treated with tangential excision and mebo or tangential excision and stsg. Data was taken from burns unit Cipto Mangunkusumo hospital in period of January to December 2011.Results: There were 30 patients (73.2%) that have been treat with tangential excision and mebo, and 11 patients (26.8%) that have been treat with tangential excision and stsg. The average length of stay for the tangential excision and mebo is 22.47 ? 23 days(SD 4.361), whereas patients with tangential excision and stsg is 15.82 ?16 days (SD 2.089). There were 8 patients (26.7%) with tangential excision and mebo that die, whereas patients with tangential excision and stsg were 2 patients (18.2%) that die. There were significant difference in the average length of stay (p = 0.018), but there was no difference in the proportion of patients dying status (P = 0.611).Conclusion:Wound care by tangential excision and stsg on 2b degree burn patient (20-25%), have a better outcome than patients treated by tangential excision and mebo.