Venous Ulcers: Testing Effects of Compression & Position

描述（由申请人提供）：慢性静脉功能不全原因 皮肤微循环的变化，导致缺氧，血液受损 血流、水肿和疼痛的静脉溃疡。这些溃疡的护理管理是 持续的挑战。围手术期护理干预包括压迫绷带 频繁的腿部抬高。重要的是护士要知道如何 加压包扎和腿部抬高的组合影响皮肤 微循环修订后的新研究者提案的目的是 确定腿部/身体位置变化和加压包扎对 微血管反应性和功能的四个关键参数。具体 目的是：具体目的1）测量基线（仰卧）皮肤氧（02），皮肤 二氧化碳（CO2）、皮肤血液灌注和下肢中的肢体体积 静脉性溃疡受试者和健康成人;具体目的2）测量皮肤 皮肤CO2、皮肤血液灌注和下肢静脉容量 溃疡受试者和健康成人对腿/身体位置变化的反应; 具体目的3）测量皮肤O2、皮肤CO2、皮肤血液灌注和肢体 静脉溃疡受试者和健康成人下肢的体积， 对加压包扎引起的腿部/身体位置变化的反应;特定目标 4)将激光多普勒流量估计的皮肤血流灌注与皮肤 通过经皮血氧测定法在吸入O2的情况下估计血液灌注 下肢静脉性溃疡受试者和健康成人的反应变化 在有和没有压迫绷带的情况下，腿部/身体位置。一家便利 将招募64名静脉性溃疡受试者和64名健康受试者的样本。科目 将在内侧测量皮肤O2、皮肤CO2和皮肤血液灌注 平卧时踝部和足部，平卧时腿抬高 300，站着。将在受试者佩戴 弹性压迫绷带基线1后测量肢体体积， 体位方案后，基线2时，体位/压迫后 方案和基线3后。为了回答目标1，将使用Hotellings T2。 为了回答目标2和3，将使用重复测量ANOVA。回答Aim 4、进行相关性分析。必须回答这些问题， 制定护理干预措施，规定最佳腿部/身体位置， 最大限度地提高愈合效果的压缩组合。

DESCRIPTION (provided by applicant): Chronic venous insufficiency causes changes in the skin microcirculation that result in hypoxia, impaired blood flow, edema, and painful venous ulcers. Nursing management of these ulcers is an ongoing challenge. Usual nursing interventions include compression bandages and frequent leg elevation. It is important for nurses to know how the combination of compression bandaging and leg elevation affect skin microcirculation. The objective of this revised New Investigator proposal is to determine the effect of leg/body position changes and compression bandaging on four key parameters of microvascular responsiveness and function. The specific aims are: Specific Aim 1) To measure baseline (supine) skin oxygen (02), skin carbon dioxide (C02), skin blood perfusion, and limb volume in the lower limbs of venous ulcer subjects and healthy adults; Specific Aim 2) To measure skin 02, skin C02, skin blood perfusion and limb volume in the lower limbs of venous ulcer subjects and healthy adults in response to leg/body position changes; Specific Aim 3) To measure skin 02, skin C02, skin blood perfusion, and limb volume in the lower limbs of venous ulcer subjects and healthy adults in response to leg/body position changes with compression bandaging; Specific Aim 4) To correlate skin blood perfusion estimated by laser Doppler flux with skin blood perfusion estimated by transcutaneous oximetry with inspired 02 in the lower limbs of venous ulcer subjects and healthy adults in response to changes in leg/body position with and without compression bandaging. A convenience sample of 64 venous ulcer and 64 healthy subjects will be recruited. Subjects will have skin 02, skin C02, and skin blood perfusion measured at the medial malleolar area and foot while lying supine, lying supine with legs elevated 300, and standing. The measures will be repeated with the subject wearing an elastic compression bandage. Limb volume will be measured after baseline 1, after the position protocol, at baseline 2, after the position/compression protocol, and after baseline 3. To answer Aim 1, a Hotellings T2 will be used. To answer Aims 2 and 3, a repeated measures ANOVA will be used. To answer Aim 4, correlations will be performed. These questions must be answered in order to develop a nursing intervention that prescribes optimal leg/body position and compression combinations that maximize healing.