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

促进压疮伤口愈合的护理技术-开发新的动物模型以阐明剪切力对伤口愈合的有效性-

基本信息

批准号：
17592199
负责人：
SUGAMA Junko
金额：
$ 2.43万
依托单位：
Kanazawa University
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
2005
资助国家：
日本
起止时间：
2005 至 2007
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-17592199/
关键词：
animal model pressure ulcer histopathology shear near-infrared device finite element model 難治性潰瘍創傷治癒

项目摘要

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.

政府于2002年引入了对不遵守压疮管理三项任务的处罚制度。由于这一制度，压疮的患病率成功降低，愈合时间也缩短了。然而，迄今为止，顽固性脓液仍然存在。 PU 愈合延迟的因素之一是剪切力。在护理干预中，例如将患者置于抬高的位置或改变体位，不可避免地会产生剪切力。在临床环境中，由于传感器有限，监测剪切力非常困难。因此，研究人员试图开发一种新的动物模型来阐明剪切力对伤口愈合的有效性。首先，我们使用我们原始的动物模型检查了剪切力强度和 PU 愈合之间的关系。向尾侧施加 8 千克压力和 0.5、1、1.5 千克剪切力，持续 6 小时。较高组的伤口愈合因坏死组织和浅溃疡发展而延迟。真皮乳头平坦，可见红细胞外渗和血栓形成。直至第 14 天，真皮中的胶原纤维与皮肤表面平行，皮下和肌肉层坏死。其次，我们尝试测量压力和剪切载荷导致的发红强度。使用近红外设备和成像软磨损，我们将红色的强度从主观值转换为客观值。坏死组织近红外线透过率相对值为31%-71%。而创面无坏死组织者为90-122%。根据这些结果，计算了预测效度并证明了良好的效度（一致率：75%）。此外，我们尝试将动物模型结果纳入有限元模型。在简单加载下完成了原型模型。