骨科英文书籍精读（34）｜骨折早期并发症之压疮
FRACTURE BLISTERS
Two distinct blister types are sometimes seen after fractures: clear fluid-filled vesicles and blood-stained ones. Both occur during limb swelling and are due to elevation of the epidermal layer of skin from the dermis (Giordano et al., 1994). There is no advantage to puncturing the blisters (it may even lead to increased local infection) and surgical incisions through blisters, whilst generally safe, should be undertaken only when limb swelling has decreased.
PLASTER AND PRESSURE SORES
Plaster sores occur where skin presses directly onto bone. They should be prevented by padding the bony points and by moulding the wet plaster so that pressure is distributed to the soft tissues around the bony points. While a plaster sore is developing the patient feels localized burning pain. A window must immediately be cut in the plaster, or warning pain quickly abates and skin necrosis proceeds unnoticed.
Even traction on a Thomas splint requires skill in nursing care; careless selection of ring size, excessive fixed (as opposed to balanced) traction, and neglect can lead to pressure sores around the groin and iliac crest.
---from 《Apley’s System of Orthopaedics and Fractures》P715-716
重点词汇整理：
BLISTER /'blɪstɚ/n. [医] 水疱；起疱剂；[冶] 气泡v. 使起水疱；起气泡；使受高温；辱骂；痛打
clear fluid-filled vesicles and blood-stained ones透明的充满液体的水泡和血性水泡
vesicle /ˈvesɪkl/n. 泡，囊；[医] 水疱
stain /steɪn/n. 污点；瑕疵；着色剂
vt. 玷污；败坏；给…着色vi. 污染；被玷污；被染污
epidermal layer 表皮层
epidermal /'ɛpə'dɝml/adj. [解剖][动] 表皮的；外皮的
dermis /ˈdɜːrmɪs/n. 皮肤，真皮
puncturing the blisters刺穿水泡
whilst /hwailst/conj. 当……的时候；与……同时；然而；虽然，尽管；直到……为止（等于 while）adv. 在……时候（等于 while）
PLASTER AND PRESSURE SORES石膏和压疮
pad /pæd/n. 衬垫；护具；便笺簿；填补vt. 填补；走vi. 步行；放轻脚步走
abate /əˈbeɪt/vt. 减轻；减少；废除vi. 减轻；失效
proceed /proʊˈsiːd/vi. 开始；继续进行；发生；行进n. 收入，获利
groin /ɡrɔɪn/n. [解剖] 腹股沟
iliac crest髂嵴；髂骨
iliac /'ɪlɪ,æk/adj. 髂的；肠骨的；回肠的
crest /krest/n. [物] 波峰；冠；山顶；顶饰vi. 到达绝顶；形成浪峰
百度翻译：
骨折水泡
骨折后有时会出现两种不同类型的水泡：透明的充满液体的水泡和沾有血迹的水泡。这两种情况都发生在肢体肿胀期间，是由于der mis皮肤表皮层的升高所致（Giordano等人，1994）。刺破水疱（甚至可能导致局部感染增加）没有任何好处，通过水疱的手术切口虽然通常是安全的，但应仅在肢体肿胀减轻时进行。
石膏和压疮
石膏疮发生在皮肤直接压在骨头上的地方。应通过填充骨点和模塑湿石膏来防止它们，从而使压力分布到骨点周围的软组织上。当石膏疼痛发展时，病人感到局部灼痛。必须立即在石膏上切一扇窗，否则疼痛会很快减轻，皮肤坏死也不会引起注意。
即使是托马斯夹板上的牵引也需要护理技巧；不小心选择环的大小，过度的固定（相对于平衡）牵引，以及忽视都可能导致腹股沟和髂嵴周围的压疮。