NURSING STUDY OF PHYSICAL ACTIVITY AND WOUND HEALING

美国每年进行2300万例外科手术， 美国，需要愈合受伤的组织或伤口。 失败 伤口愈合的影响导致发病率、死亡率和健康状况的改善 住院时间延长导致的护理费用和 治疗 除了限制伤口感染的技术外， 手术后的愈合和恢复被认为是通过早期 术后活动。 体力活动对伤口愈合的影响 以及对修复至关重要的变量，血流和氧气水平 在外周组织中尚未确定。 更好地理解 身体活动如何影响这些因素将指导发展， 促进最佳伤口愈合的临床活动计划， 从手术中恢复过来。 本研究的具体目的是：1）确定是否增加 术后活动可促进伤口愈合， 愈合的亚细胞标志物，2）描述增强的效果 对皮下氧（PscO2）和血流量的活性，以及，3）描述 皮下灌注/氧和细胞内 愈合的标志 采用随机、两组实验设计 计划接受全髋关节置换术的受试者将参加 常规术后活动（n = 28）或5天增强 术后活动方案（n = 28）。 将评价伤口愈合情况 通过分析组织细胞结构，前α 1 [I]胶原蛋白的mRNA和 从一个小的， 皮下放置聚四氟乙烯管，7日取出 术后一天 PscO2和血流量将在 手术和接下来的两个术后天使用光电二极管/眼压计 系统 组间在愈合、组织氧和 灌注变量将采用Student t检验、ANOVA进行检验， 重复测量，或Mann Whitney U检验，取决于 测量. 关系将被测试与皮尔森的产品时刻 或斯皮尔曼等级相关系数。

Twenty-three million surgical procedures are performed annually in the United States, requiring healing of injured tissues or wounds. Failure of wound healing contributes to morbidity, mortality and increased health care costs resulting from longer hospital stay and increased costs of treatment. Beyond techniques to limit wound infection, the promotion of healing and recovery after surgery are believed to be improved by early postoperative activity. The effect of physical activity on wound healing and variables that are critical to repair, blood flow and oxygen levels in peripheral tissues has not been determined. A better understanding of how physical activity effects these factors will guide development of clinical activity programs that promote optimal wound healing and recovery from surgery. The specific aims of this study are to 1) determine if augmented postoperative activity enhances wound healing as measured by cellular and subcellular markers of healing, 2) describe the effect of augmented activity on subcutaneous oxygen (PscO2) and blood flow and, 3) describe the relationships between subcutaneous perfusion/oxygen and cellular markers of healing. Using a randomized, two group experimental design subjects scheduled for total hip arthroplasty will participate in either conventional postoperative activity (n=28) or a 5 day augmented postoperative activity protocol (n=28). Wound healing will be evaluated by analysis of tissue cellularity, mRNA for pro alpha1[I] collagen and hydroxyproline from a tissue sample obtained from a small, polytetrafluoroethylene tube placed subcutaneously and removed on the 7th postoperative day. PscO2 and blood flow will be measured on the day of surgery and the next two postoperative days with an optode/tonometer system. Differences between groups on healing, tissue oxygen and perfusion variables will be tested with Student's t test, ANOVA for repeated measures, or the Mann Whitney U test depending on the level of measurement. Relationships will be tested with Pearson's product moment or Spearman's rank correlation coefficients.