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A. l CAIIMAHO'&, eonoauuil cne4ianicm fi,enapmaueumy deptrcaeuozo

canimapno-enibeuionozi'ruoeo uaznndy MO3 Yrcpainu

I HQi ryeaHHn naqiexra eig6yeaerucn enacnigor nopyueH Hfl n paBnn acenru-Kvr nepcoHanoM 3aKnaAy oxopoH14 :gopoe'n ni4 vac npoBeAeHHfl MeAnLtHux npo-LleAyp. llepegaeanxn mirpoopraHisnnie qepe3 pyKn 3anexnru aig en4y mixpo-oprauirtlnie, Mo)flHBocri li etaxneaHHfl Ha pyKax, cryneHn xonranninaqii pyxror{o. Bxnrrs sano6ixFrvrx aaxo4ie, cnpflMoBaHux Ha sa6esneqeHHfl inQexqift-xoi 6esnexu naqieHra y 3aKnaAax oxopoHl4 3gopoe'n, e o6og'RgxoM KoxHoroMeAnr.rHoro npaqienura.

BignoeiganuHicru aa npoBeAeHHfl KoMnneKcy aaxogie uloAo 6oporu6n s aHy-

rpiurnuonixapHnHrMr4 inQexqinrvrn (Bfll) noxnaga€rbcn Ha ronoBHoro nixapn i aa-

aigyeauie eigginenu 3aKfla4y oxopoHt4 s4opos'l. Crapuri uegnuni cecrpn eiggi-neHb npoBo4nru incrpyKrax cepeAHboro ra MonoAuroro Me4n'{Horo nepcoHany3 Br4KoHaHHr KoMnneKcy saxogis, cnpnMoBaHnx Ha nonepeAXeHHR inQiryeatunnaqienra nig uac npoBeAeHHF niryeanuHnx ra 4iaruocn4t{Ht4x npoqe4yp.

3axo4u npoQinaxrraxrrr inQixyeannR naqiexra noKnrKaHi geecrn Ao uiHi-MyMy pl,i3!rK KoHraKry naqienris i npaqieHrarie I ixQixoaaHnMh uarepianamn.OcHosxnrvlu sano6ixnvrrvlvt 3axoAaMil iHQixyeaHHn naqienra y 3aKnagax oxopo-nu agopoe'fl € Mhrrfl pyK ra BuKopl4craHHn pyKaB[qox. .[iT MeAnqHoro npaqie-Huxa, axi rpyHrynrbcn Ha nprnytqenni, qo aci naqieurn Moxyrb 6yrr noreH-r1ifi no iH$ixoeanraMvr, cnpufl roru sa6esneqeHHo 6inuruol 6esnexn nopiennuos au6iproshM 3acrocyBaHHflM craHAaprHt4x Eano6ixnux aaxo4ie no eigno-ueHHo nnue Ao oKpeMux naqienrie.3aeigysaui eiAginehru pa3oM ia crapu.tutvtttMeAvrqHl4Mr4 cecrpaMvr opranisoeyoru i xonrpontotclrb Bt4KoHaHHfl MeAnqHuMnepcoHanoM qHX saxogia.

locn iAxennn, qo rgi ft cx toBar hcr Bn poAoBX ocra H H boro cton iTTr, ceiA.{aru,ulo Mytrur pyK € oAHl4nn ie nafieQexrreFriul4x cnoco6ie npoQinaxnaxra iHQexqifiy 3aKnagax oxopoHr4 sgopoe'n. O4nax 3HaqeHHr r-lboro sano6ixnoro 3axoAy, He-

3Baxaoqil Ha rioro KnpqoBy ponb y gnnxenni pn3nKy nouupeHHn iHQexqii vacroue4oorliHoerucn.

Ha uripi nloAnHV nocrifiro npncyrxi mixpoopraui3mu, tax 3BaHa pe3hgeHr-na (nocrirlna) Qnopa, Rxi eaxxo Bn4annrn 3a AonoMorop ruexaHiqHoro reprn

76 Inr npoaigrrx npaqieurxie lauagy oxoporn tgopot't trlf,tE

P060TA ff PEIH b0f0 Mtllil'{ H0r0 nIPCollAJlv . (tllEllllPiltl

(nanpnxna4, Uirxoo). Ane icnyoru nnixpooprani3Mr4, lqo norpannrorb Ha urxipys nporleci po6orvr a6o sauqaliuol xurre4innuuocri nloAvtHt , raK 3BaHa yMoBHo-naroreHHa nnixpo$nopa, ffKa flerKo BnAanfl€rbcn TeprrM i mnrrRm pyr aogoro isgenqafiHnM MnnoM qr iuurnu MnoqtaM saco6orvr.

flig vac po6orr,r noBepxHr pyK MepnqHoro nepcoHany Moxe 6yrr,r neogHopa-3oBo KoHraMiHoeaHa norenqiftHnun mixpoopraui:mamn - z6ygnnxamra iHQex-tlitlxvrx xeopo6. Torrny, naeiru flKrqo MeAnvnni nepcoHan npaqp€ B pyKaBnqKilcr6epiraerucR He6esnexa inQiryeaHHn naqieHris ra inu.lrx Me4uqHnx npaqiearaxie.

fiorpnuannn MeAilqHnM nepcoHanoM npaBnn i rexxixn Mnrrfl ra aHrncen-TnKV pyK, BI4KOpUCTaHHfl pyKaBnqOK He nnure AO3BOnnrb nonepeAnTn BnHnK-HeHHF sFraqxoT rinurocri 3axBoproBaHa, a h cnpuflrnMe paqionanuuoMy Br4Ko-pucraHHto rouirie.

fieronramiuaqin pyr MeAyrqHoro nepcoHafly Aocflra€rbcfl rurrflxoM Mr4TTr pyK,

o6po6xra u.rxipra pyK aHrncenrvKaMt , xipyprivnoT aHTncenrnKn.Me4uvxufi nepcoHan nnae nocrifiHo npoxoAl4rn HaBqaHHR r{ogo npolleAyp

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. nicnfl $iauunoro KoHraKry s 6ygu-nxumu iucrpyuenrannu a6o npeAMera-nnn, rKi Moxyrb 6yrn xonrauiHoeaFri xpoB'lo ttn iHrunmn pipxvrrvrra cepe4o-Bilu{aMn oprauismy, a6o nicns Qisuvnoro KoHraKry gi cnilsoen[4n o6o-flOHKAMN;

. niclg aigeiAyeannfl ryanery;o nePeA npnroryBaHHnu i posgaqep'rxi;.y Bcix iHu.ryrx BrnaAKax, Konn pyKl4 sa6pygneni.

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yMnBanbHuKax He Ao3Bonff€Tbcn. Tpnuavi 4nn nanepoBvrx pyurHnxie (cepee-rox) xpinnnru 6esnocepeAHbo HaA yMyrBarrbHl4KoM y cneqianounx npncrporx.

Y 6inuu:ocri euna4rie KoporKe (npornrou 10-15 ceryn4) Mt4rrn pyK nporot{-Horo BoAolo si :enqailxhM MnnoM 3 noAanbunm cnonicxyeaHHflM ni4 crpymenerur

IltrlDliltlil},npaenirHn:aruusonr 0xop0lr4 3ropoB'n 77

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flexoamaninaqinpyxueduunozo

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wnnxoM Mummfl pyK,

o6po6xu wxipu pyx

0HmucenmuKoMu,

xi py pziu n oi an m ucenm u Ka

BoAr4 € gocrarxim Anr Bnganernn mixpoopraxi:tuie i 6pygy fi sacrocysaHHr aH-

rncenrilKa ne norpi6xo. flicns Mnrrfl pyK nepeA noqarKoM meguuHol npoqe4ypl4xe cni4 TopKarucn 6yga-axnx HecrepunbHnx noBepxoHb, qncrltx crepnnuunx ix-crpyruenrie a6o ixunx npe4merie Ao HaAtraHHn pyKaBn'{oK.

Y saxna4ax oxopoHr4 sgopos'R g o6l\nexeFtnnnn marepianbHvlMt4 pecypcaMn

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O6po6xa pyK aHrucenrnKoM

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o nepeA i nicns npoBeAeHHfl rvraxinynnrlirl, noB'f3aHnx 3 MO)KnnBnM ra RB-

HnM nouKoAXeHHflM ulripra h cnngoevx o6ononor naqieura (o6po6xa

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. npn KoHraxri ai crepunbHilM Marepianou ra ixcrpymexrapiem;

. nicrs xoHrarria: 6iocy6crparaMn xBoporo (rpos, nirsop, ceqa roqo);

.nicnF KoHTaKry s a6ioreHHnmu o6'ertamn, norenqifiuo xontaminoBaHh-mr rocn iran uxoto tvti xpoQnoporo (n punagn, Karerepvl, 3oHA14 roqo);

. niA qac Aorn AAy sa naqienraun ,KontA nicnn o6po6xra aa6pygnennx micqu

neo6xigxo nepefiru Ao ttl4crl4x;

o nePeA i nicnn HaAflraHHf MeAnqHhx pyKaBnqoK;o nePeg BnxoAoM 3 nanarn.

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co6u rvroxyru sano6iratn h'ix po3Bl4rKy,3arexHo aig nany aHrilcenrrKa ra mi-

xpoopraxi:vry. Anrncenrvnn He npu3Haqeni 4nn o6po6rrrr incrpyruenrie i no-eepxni npegmerie. Bosn gacrocoBytorbcn nnue AnF xipyprivxoT o6po6xr,r pyx,y craryaqinx, noB'fl3aHnx : ni4suuleHuM pt43l4rorvr ixQiryBaHHF, HanpnKna.q,

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s noaepxni u:ripr,r 6pyn. Ueft MeroA ririeniqnoi o6po6xvr Moxe 3acrocoByBarucrnpur aigcyrxocri soeHiurHix osFtax ra6py4nennn noeepxHi pyx no6yroenrvr 6py-goru, rpoa'o qn iuurnmn opraxivuumu peqoBilHamr (nanpnxnaA, y nepepeax l,tix

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Ha e iucrpyxqii ulogo rloro aacrocyBaHHfl;.eHeprirlHo BTnparn flo noBHoro Brc4xaHHF aHTncenrnKa He MeHule

1 5 ceryug;oH€ BylTt4pdTApyKVl.

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i ni4sieurra xucri pyr euqe pieHn nirrn;. npocyuJHrH pyKu 3a AonoMorop crepunbHnx cepBeroK (pyurnraxa);.HaHecr[ Ha AonoHp xeo6xigny xinuxicru aHrhcenrnKa eiAnoeiAHo 40iHcrpyxqii, ane He MeHUe 3 run, i eneprifixo Bruparh fioro e uLxipy ne-pegnniuua BKrloqHo s nirTboeilf\nn cyrno6aur Ao noBHoro BncnxaHHf.flpyroo nopqiero aHrilcenrilKa o6po6nnrorb pyKl4 Ao cepeAuHn nepeA-nniqqs. Tperuoro - nnue xncri pyr ga rexnixoro Mnrrfl pyK 3 Br4Kopr,rc-TaHHFM pigxoro MVna;

o plKh BACyWnru noeFticrlo (s ueroo nonepe.qxeHHfl pO3MHOxeHus rvrix-poopraxirmie y eonoromy cepeAoBl4r4i), norim HaAflrrr crepnnunnfi xa-nar i crepnnuri pyraeuvxvr;

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Meduunuu nepcoHor Moe

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mepmu eenuxi nanoqi pyx

3.Tepmu dononi zi cxpeueuuMu po3-

eedenuuu nanaqauu ne meuwe I xe.

6. I7o uepzi pisuocnpflMoBaHuMu Kpy-

?oeuMu pyxaMu mepmu dononi xiu-.1 u KoMu nonbLli e npununexuoi' pyxu

Br,r xopncraH Hr' MeAnq H nx pyKaBuqoK

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raxr is KpoB'to a6o isu.ryrrvryr pigxrarvua cepeAoBr4r4aMn, npvr po6ori s iucrpyuenrauu

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pncraHHfl nignnraoru yrrnisaqil.

l.Tepmu dononi odna o6 odny

80 Im nposiasux npaqigHrxie raKnaay oxopoHu 3nopog'fl=lilMl

P050TA (EPEIHb0r0 MEAIr{H0r0 nEp(0HAIy o CAHEnllPEXnt

He 4onycxa€Tbcfl:.Mr4rrfl a6o o6po6xa aHrrcenr[KoM pyK y pyKaBnqKax nig qac nepepB

y ruaninynnqinx;oMvrrrf a6o o6po6xa pyK y pyKaBilqKax uix npoBeAeHHflM (r{ncTux)

i <<6pygHrrrx> maninynnqiri, HaBirb oAHoMy naqienroai;o nepecyBaHHf B pyKaBilqKax y ei4ginenxi (-nx) craqioHapy.

Cni4 nau'nrarn, lqo nepeA HaARTaHHFM pyKaBrqoK He MoxHa Kopt4cryBarilcnsaco6amr, Rri uicrsru uinepanuxi Macfla, Ba3eniH, nanonit.

Tnnn pyxaBuqoK, t4o BltKopltcroBytorbcf, B 3aKragax oxopoHl,t 3Ao-poB'n:

Y ue4u.rniri npaxruqi BrKopucroByrorb rpt4 runil pyKaBnqoK:.xipypriqni.3acrocoeyorbcfl B ycix ernagxax, Konu uae uicqe xonraxr i:

ni4u.txipnurrnil TKaHilHaMu a6o eugineHHflMl4 rpoai. fli.q vac qnx npolle-Ayp AoqinuHille anxoplrcroByBarn crepunuHi pyKaBuqKn; AonycKa€rb-ca il enxopucraHHfl xipyprivHux, nxi npofir.unra 4eeixQexqiro. XipyprivnipyKaBt4r{ Kt4 Bt4Kopt4croBytorbcn n pil n poBeAeHx i i H easu BHux MeAnq H uxBrpyqaHb ra npu xipyprivxnx npoqegypax.,[nn onepaqiri emxopncroay-orb nareKcHi ra xeonpenoei pyxaauvrn;

roHrf,AoBi. L-li pyxaaravxr, Rxi ga6egneqyorb 3axucr MeAnepcoHany npneu xoxa H Fl i 6a raruox MeAn q H vrx rvra n i nynn qi rl, Ma |orb Bt4 Kopt4 croB y Barv-cfl npu xonraxri si cnnsosilrvlr o6ononxamr. OrnR4oai pyxaarvxv 3Bn-qaftno BuroroBnrorbcn 3 ryun (narexcy) a6o sininy i vroxyru nocraBnff-rtAcfl B poscunnirl a6o ingraai4yanuxirl ynaroaqi. pyxaervxu tlboro runye v.ncrnMn, ane He crepilnbHuMu. frna ornngie BuKopt4croBytorb nareK-csi il raxrunonoai pyxaanvxra. flig qac AornffAy sa naqienroM Br4Kopt4c-roBylorb nateKcn i, nonierrnexogi ra non iei Hinxnopn4ni pyxa arav xu. 11 ic-nR 3acrocyBaHHfl BoH t4 noeil Hx i 6ytn ytunisoeaxi;

.rexHiqHi (no6yroei) a6o qinuni rocnogapcuxi pyxaenqKr. !i py-KaBuqKu ra6ernevyorb 3axilcr MeAnepcoHany npu o6po6r1i o6nag-HaHHfl, sa6pygnennx noBepxoHu, incrpyuenrapio, npra po6ori s eiA-xo,qaMn MeAuqHilx saxna4ie. Lllinuni ryrrnoei pyKaBilqKu Bt4Kopt4cro-Byrorbcfl nig vac KoHTaKry is sapaxeHrur incrpyMeHraMr ra iHulu-Mu npeAMeraur, aigxoAaMn, nocrinusoto 6inulxoro, a raKox nig vacnpr6npannn npurvrir4euu ra o6po6xn :apaxeHrx noBepxor.ru. TaxipyKaBilqKr MoxHa BilKopt4croByBartA HeoAHopa3oso nicns perynnp-soro cnonicKyBaHHfl.

Bnruoru Ao MeA[qHtax pyKaBuqoK, l4o BytKopltcroBytorbcr:1. Pyxasnvxu Maprb 6yna eignoeigHoro poaruipy 3 ypaxyBaHHFM xapaKrepy

n poqeAyp (rvra H i nynn r1i rl), r4o Brl KoHylorbcn.2. Pyraeuuxil noeilHFti :a6esnevyaaru B14coKy raKrulbHy vyrnueicru.3. M icrnrn vi n ivan uHy xin uxicru a Hrr reH i e (narexc, nareKc-n poreTn ra).

Br6u pa ouu ue4rv ui pyKaBWtKu, BpaxoBytorb ruoxn rei aneprivni pea xqile aHaf\ Hesi naqieHria na uarepian, 3 flKoro BuroroBneHo pyKaBnttKr. flnn npo-BeAeHHF nepeAcrepunisaqifi Hoi oqrcrKrt rocrporo MeAnr{Horo iucrpynnenra-pi o cn i4 Br4 Kopr4croBy Bar n pyKa Br q Kr 3 reKcrypoBa H oo :oex i ur H boro noBepx-Helo.

flpu nideomoeqido

n p o sedeH H n xi py p zi|.t H ux

n p o qedy p p e Ko M e H dy em bcn

xipypziuno o6po6xa

pyxisncmocyeoHHnM

0 H m u ce n m u,t H o 20 30co 6y

npomneom 3-5 xeunua

p0601A cEpEgHb0f0 MIAHqH0r0 nEPc0HAflv I cAHEnIAPEXIIM

fleped nodnzonnnn

pyKqsuqoKHe MuKHq

Kopu cmy so m u cn so co6 o utu,

nxinicmnmo minepanoni

Mocro, eogenin, nanonin

fl paeuna BtaKopncraHHt pyKaBHqoK:1. Crepununi pyxasrvxn o6oe'R:roao BnKopvtcroBylorb npn:

o ycix xipyprivnnx oneparnBHvrx BrpyqaHHFX;. iHea3u eFrvrx uaHi nynnqinx;otBefleHHi crepilnbHoro ronKoo e rnyr6oxi rKaHnHn a6o pi4ranvr opraHi:tuy ni-

xapcurrx Qopvr (enyrpieeHHi inQy:ii orpvtMaHHfl 6ionpo6 gnn AocniAxenu);olcrdHoBn€uHi xarerepa a6o npoeiAHvlKa t{epe3 uxipy;. MaHinynrqiflx, noB'R3aHvtx 3 KoHTaKToM crepnrbHoro incrpymexrapio

s i Frta rrH il u u cnn3oBtAMn o6ono n xaun (qucrocxon iR, xatetepu ra qin ce-qoBoro uixypa);

o ornfAi xipyprivuol panr;. 6pouxocronii, enAocxoniT unyuroeo-Kr4rxKoBoro rpaKry canaqif rpaxei). BBefleHHi nepraQepifinoi eHyrpisennol a6o aprepianunoT xaspni.

2. Hecreprnuni qrcri pyKaBnqKil Bt4Kopl4croByoru nig vac:. po6orvr s 6ionoriqFtnu marepianom ei4 xeopux;.sa6opy rpoei;. n poBeAeHHn suyrpi un uoM'f 30Bl4x, exyrpieen n mx iu'exqi ft ;

. BI4KOHaHHF OqncrKl4 ra gesirQexqil.

HOPMAT]4BHI AKTl4

M flpuxar Munucrepcraa 3ApaBooxpanenun CCCP <06 ynyvuexnh MeAuquHcKofi nououlu

6onururvr c ruofiuurrur xupypruqecKhrur ga6oneeaH neMV u ycvneHtAn tueponprannafi no 6opu6e

c enyrpra6onuruqsofi ranSexqueti> aig 31 nrnun 1978 p. Ne 720.

M llprrrra: Mrxucrepcrea 3ApaBooxpanenun CCCP <06 yreepxgeuun VncrpyKqHr no

caHurapHo-nporr4BoanuAeMilqecKoMy pexnMy il oxpaHe rpyAa nepcoHana unQexqraouuutx 6onu-

nnLl (orAeneuufi)> eiA4cepnHn 1983 p. Ne 916.

M Haxag Miuicrepcrea oxopoHvl 3AopoB'fl Yxpaiuu <[1po eareepgxeHHn MeroAt4'{Hr4x peKo-

rvrexAar1ift <Enigeuionoriluuft uarnng ta ixQerqinnu o6nacri xipyprivuoro BrpyqaHHff> ei4 4 xeir-

us 2008 p. No 181.

M lno6anuuan crparerhn no cgepxuBaHuo ycrofivreocru K nporl4Botuuxpo6nuu npena-pararvr. / flparruvecxoe pyKoBoAcrBo. BO3, XeHesa. - 2001. - WHO/CDS/CSR/DRS/2001.2.

82 Ann npoeiflflux npaqisHuxisgaxnaAy oxopoHn 3gopoe'n

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