SUGAMA JUNKO

Under the pressure loading of 30, 90, 180 or 270 mmHg, the blood flow and hyperemic responses were investigated in the superficial and deep skin tissues of the right heel of 9 healthy females, 20-21 year old. The temperature and blood flow in the superficial skin tissue, and the levels of oxidized, reduced and total hemoglobin in the deep tissue were monitored. The kinetic analyses were also made before, during and after the loading of above mentioned pressures at heel region for 30 minutes. The blood retention and tissue damages seemed to occur under 270 mmHg loading. The hyperemic response in the deep tissue increased as the pressure loading was strengthened. However, such an inclination was temporary and returned to normal level in a short period. Taken together the present results suggest that the superficial skin is more sensitive to pressure loading than the deep tissue under 270 mmHg loading.

To evaluate the effectiveness of support surfaces and massage as management for prevention of pressure ulcers, we measured the transcutaneous oxygen tension (TcPO₂) at sacral resion in healthy subjects. The ratio of TcPO₂ values taken during pressure application for 60 minutes to TcPO₂ values before pressure application was compared between treatment of three support surfaces (ring cushion (donut-type), air-mattress, urethane foam-mattress) and treatment of futon, mattresses pad as control. The significant difference of TcPO₂ ratio had been demonstrated among each support surfaces. The decreases of TcPO₂ ratio were less in the subjects treated with, in order of significance, ring cushion, air-mattress, urethane foam-mattress, futon, mattress pad. The recovery time of TcPO₂ after relief of pressure that returns to the same level prior to application of pressure was analyzed in the subjects with or without treatment of massage prior to for 5 minutes pressure application. There was no significant differences between recovery time of subject treated with massage and that without treatment. These results suggest that air-mattress is most effective for prevention of pressure ulcer development as support surface and it will be necessary to re-evaluate the significance of massage treatment in prevention of pressure ulcers

1)褥創あり群はなし群より最大体圧・平均体圧・危険圧と,32mmHgより高い体圧を含めて体圧のかかる面積が大きい値を示し,褥創発生の危険の高い状態にあった。2)褥創あり群は経時的には体圧のかかる面積や最大体圧のかかる部位の変化が大きかった。3)褥創あり群は体動が多く,同一姿勢を保持する時間が短かった。体動の要因として不良姿勢の補正が考えられ,体動の結果ずれが生じ,褥創の要因となっている老人の車椅子座位では,座面がより安定した構造で,対象の姿勢保持能力を把握してポジショニングをいかに整えるかが重要である

Pressure Sores are a serious problem within the post operative patients especially elderly and critical patients that can lead to pain, longer hospital stay, and slower recovery. The purpose of of this study was to evaluate an original version of Criteria on Application of Air Mattress after Surgery (CAAMS) using the Japanese Version of Braden Scale for Predicting Pressure Sore Risk. The subjects were 164 post operative patients who were indentified no pressure sore after general surgery in a hospital specialized for tertiary care. The incidence of pressure sore and its stage were compared the patients who were employed the CAAMS with control group (traditional nursing assessment). The incidence of pressure sore applied this criteria was 0%, and control group was 9.0% (six patients). Four pressure sores (4 people) were rated as Stage Ⅰ, and two pressure sores (2 people) were Stage Ⅱ. The investigators believe the CAAMS is promising preventive tool of pressure sore for patients after general surgery.