Nursing technique for promoting wound healing of pressure ulcer-Development of a new animal model to elucidate effectiveness of shear to the wound healing-

政府在2002年引入了一个惩罚制度，惩罚未能遵守压疮管理三项任务的人。由于该系统，PU的患病率成功地降低，愈合时间也缩短了。然而，难治性脓迄今为止仍然存在。PU愈合的延迟因素之一是剪切。剪切力不可避免地发生与护理干预，如定位患者在头部抬高的位置或位置的变化。在临床环境中，由于传感器有限，因此很难监测剪切力。因此，研究者试图开发一种新的动物模型来阐明剪切对伤口愈合的影响。首先，我们使用我们的原始动物模型检查剪切力强度与PU愈合之间的关系。向侧腹区域施加8 kg压力和0.5、1、1.5 kg剪切力，持续6小时。高剂量组的伤口愈合因坏死组织和浅层溃疡的发展而延迟。真皮乳头平坦，可见红细胞外渗和血栓形成。直至第14天，在真皮、皮肤表面和皮下及肌肉层中观察到胶原纤维坏死。其次，我们试图测量由压力和剪切载荷引起的发红强度。使用近红外设备和成像软磨损，我们转换的强度从主观值的发红的客观值。坏死组织近红外线透过率的相对值为31 - 71%。而无坏死组织的创面愈合率为90- 122%。根据这些结果，计算预测效度，并显示出良好的效度（一致率：75%）。此外，我们试图将动物模型的结果纳入有限元模型。在简单加载条件下完成了原型模型的制作。

Government introduced penalty system for failure to comply with the three tasks for pressure ulcer (PU) management in 2002. Owing to this system, the prevalence of PU successfully reduced and a healing time was also shortened. However, refractory Pus have remained to date. One of the delayed factors for PU healing is shear. Shear forces occur inevitably with nursing interventions such as positioning patients in head-elevated positions or position changes. In clinical settings, it is very difficult to monitor shear forces because of a limited sensor. Thus, researches try to develop a new animal model to elucidate effectiveness of shear to the wound healing. Firstly, we examined the relationship between the intensity of the shear force and PU healing using our original animal model Eight kg of pressure and 0.5, 1, 1.5 kg shear toward the caudal side were applied for 6 hours to the flank region. The higher group's wound healing was delayed by the necrotic tissue and the shallow ulcer development. Papillary dermis was flat and extravasations of red blood cells and thrombosis were seen. Collagen fibers in the dermis paralleled skin surface and subcutaneous and muscle layer necrosis were seen up to Day 14. Secondarily, we tried to measure the intensity of redness resulting from pressure and shear loading. Using a near-infrared device and an imaging soft wear, we converted the intensity of the redness from subjective values to objective values. The relative values of permeability of near-infrared rays in the necrotic tissues were 31 -71%. While those in the wound without necrotic tissue were 90-122%. According to these results, the predictive validity was calculated and demonstrated good validity (agreement rate: 75%). Moreover, we tried to incorporate the animal model results into a finite element model. A prototyped model was completed under the simple loading.