Promote pressure ulcer healing in individuals with spinal cord injury using an individualized cyclic pressure-relief protocol.
Promote pressure ulcer healing in individuals with spinal cord injury using an individualized cyclic pressure-relief protocol.
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DOI：
10.1097/01.asw.0000305495.77649.ee
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发表时间：
2009-11
影响因子：
2.4
通讯作者：
Chen D
中科院分区：
文献类型：
--
作者：
Makhsous M;Lin F;Knaus E;Zeigler M;Rowles DM;Gittler M;Bankard J;Chen D
评估个体化周期性减压方案是否加速患有压疮（PrU）的轮椅使用者的伤口愈合。随机对照研究。脊髓损伤的治疗方法将44例年龄在18-79岁的II期或III期PrU受试者随机分配至对照组（n = 22）或治疗组（n = 22）。治疗组的受试者使用配有可单独调节的自动座椅的轮椅，该座椅可提供循环压力释放，而对照组的受试者使用标准轮椅。在PrU治疗期间，所有受试者每天至少坐在轮椅上4小时，持续30天。使用压疮愈合量表（PUSH）工具评估伤口特征，每周两次用数码照片记录伤口尺寸。比较两组之间相对于初始测量值30%愈合的中位愈合时间、伤口面积减少百分比和试验结束时PUSH评分改善百分比。在30天结束时，两组均表现出愈合的总体趋势。然而，发现治疗组与对照组相比，伤口测量达到30%愈合所需的时间显著更少。使用循环固定时，伤口面积和PUSH评分的改善百分比更大（45.0 ± 21.0，P <0.003; 29.9 ± 24。6，P < .003）与标准座椅（10.2 ± 34.9，5.8 ± 9.2）相比。作者的研究结果表明，周期性地缓解坐姿个体伤口区域的压力可以极大地帮助伤口愈合。目前的研究提供的证据表明，个性化的周期性减压协议有助于促进压力伤口愈合的临床设置。作者得出的结论是，个性化的周期性压力释放可能在加速现有PrU的轮椅使用者的愈合过程中具有实质性益处，同时在PrU治疗期间保持SCI患者的活动性。
To evaluate whether an individualized cyclic pressure-relief protocol accelerates wound healing in wheelchair users with established pressure ulcers (PrUs). Randomized controlled study. Spinal cord injury clinics. Forty-four subjects, aged 18–79 years, with a Stage II or Stage III PrU, were randomly assigned to the control (n = 22) or treatment (n = 22) groups. Subjects in the treatment group used wheelchairs equipped with an individually adjusted automated seat that provided cyclic pressure relief, and those in the control group used a standard wheelchair. All subjects sat in wheelchairs for a minimum of 4 hours per day for 30 days during their PrU treatment. Wound characteristics were assessed using the Pressure Ulcer Scale for Healing (PUSH) tool and wound dimensions recorded with digital photographs twice a week. Median healing time for a 30% healing relative to initial measurements, the percentage reduction in wound area, and the percentage improvement in PUSH score achieved at the end of the trial were compared between groups. At the end of 30 days, both groups demonstrated a general trend of healing. However, the treatment group was found to take significantly less time to achieve 30% healing for the wound measurement compared with the control group. The percentage improvement of the wound area and PUSH scores were greater in using cyclic seating (45.0 ± 21.0, P < .003; 29.9 ± 24. 6, P < .003) compared with standard seating (10.2 ± 34.9, 5.8 ± 9.2). The authors' findings show that cyclically relieving pressure in the area of a wound for seated individuals can greatly aid wound healing. The current study provides evidence that the individualized cyclic pressure-relief protocol helps promote pressure wound healing in a clinical setting. The authors concluded that the individualized cyclic pressure relief may have substantial benefits in accelerating the healing process in wheelchair users with existing PrUs, while maintaining the mobility of individuals with SCI during the PrU treatment.