Development of standard care evaluation of pressure ulcers by the molecular biological approach

本研究旨在探讨难治性压疮中细胞因子的变化及其与创面愈合过程的关系。我们研究了压疮和伤口变化模式中的细胞因子，以澄清细胞因子在每种状态下的行为。3天和7天后更换护理，测量保留的细胞因子渗出液的水平；白细胞介素l - α和1β (IL-lα, 1β)、碱性成纤维细胞生长因子（bFGF）、血小板源性生长因子- ab （PDGF-AB）、白细胞介素4 （IL-4）、转化生长因子-β1 （TGF-β1）和血管内皮生长因子（VEGF）。每周观察伤口。所有受试者都同意参加这项研究。细胞因子在每次伤口变化时都增加：对于破坏粘附，它是7 / 7 （VEGF在7 - 3天升高）；肉芽增加，8 / 8 （bFGF在3天后）；上皮化也有80% （bFGF在3天后）。压疮的标准护理评估是根据这些结果制定的。我们的标准护理评价结果为：bFGF阳性预测值70.0%，VEGF阳性预测值66.7%。因此，建议我们的压疮标准护理评估是有效的。

The purpose of this study was investigated the change in cytokines in refractory pressure ulcers and relationship between its changing and wound healing process. We investigated cytokines in pressure ulcers and wound change patterns in order to clarify cytokine behaviour at each status. After three days and seven days changing care measurements were performed of the levels in retained exudate of the cytokines; interleukin lα and 1β (IL-lα, 1β), basic fibroblast growth factor (bFGF), platelet-derived growth factor-AB (PDGF-AB), interleukin-4 (IL-4), transforming growth factor-β1 (TGF-β1) and vascular endothelial growth factor (VEGF). Wounds were observed weekly. All subjects had consented to participate in the study. Cytokines were increased at each wound change: for undermining adhesion, it was six out of seven (elevation in VEGF at seven three days); for increased granulation, eight out of eight (bFGF at after three days); and for epithelialization also eight out of ten (bFGF at after three days). Standard care evaluation of pressure ulcers was developed from these results. The results of our standard care evaluation were as follow: positive predictive value of bFGF 70.0% and positive predictive value of VEGF 66.7%. Therefore, it was suggested that our standard care evaluation of pressure ulcers was effective.