| 特集名 | CAPD出口部の新しいスキンケア | |
|---|---|---|
| 題名 | 各論 (3) 電解酸化水を用いたスキンケア | |
| 発刊年月 | 1997年 05月 | |
| 著者 | 中原 貴子 | 熊本中央病院・看護婦 |
| 【 要旨 】 | CAPD出口部ケアにイソジン液を使用してきたが，イソジン液過敏反応と思われる皮膚症状とそれに起因する出口部感染がみられるようになった．このため，イソジン液過敏反応を示す患者に電解酸化水による出口部ケアを試みた． 当初使用した強酸化水は，1%以上の有機物の存在により殺菌効果が消失する，金属腐食作用が強い，消毒効果時間が短いなどの欠点を有しカテーテルの変色もみられた．このため，弱酸化水に変更し使用した．弱酸化水は有機物の不活化を強酸化水の10倍受けにくく，残留塩素が安定しているため消毒効果時間が長い．弱酸化水へ変更後新たなカテーテルの変化は起こっていない．しかし，電解酸化水使用により過敏症状を示す患者もおり，患者の皮膚に応じた消毒方法の選択が必要となる． 看護者は患者の皮膚症状の観察のほかに，消毒薬の特性に応じた取り扱いができる知識，技術が必要となる．そのうえで，患者に出口部管理の重要性を指導していくことが大切と考える． |
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| Theme | New Skin Care of Exit Site in CAPD | |
|---|---|---|
| Title | Skin care with electrolyzed water | |
| Author | Takako Nakahara | Hemodialysis Center, Kumamoto Chuo Hospital |
| [ Summary ] | Povidone-iodine (Isodine) was formerly used to sterilize CAPD catheters and exit-sites, but some patients suffered allergic skin reactions and developed exit-site infections. As a substitute for Isodine, acid electrolyzed water was used. However, the sterilizing effects of strong acid electrolyzed water (pH <or= 3) were inhibited by the presence of organic substances with a concentration of 1% or higher. At present, soft acid electrolyzed water is being used, eliminating the problems of corrosiveness, catheter discoloration, and short term sterilization. Soft acid electrolyzed water, being much less affected by the presence of organic matter, is ten times more stable than strong acid electrolyzed water and because it maintains the concentration of residual chlorine it provides sterilization for a much longer period than strong acid electrolyzed water. Though there were no problems involving CAPD catheters, some patients reacted adversely to acid electrolyzed water. Special care must be taken in selecting disinfectants that are appropriate for both the patient's skin and the catheter, and all CAPD patients must be taught the importance of proper exit-site care. |
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