Venous Ulcers: Testing Effects of Compression & Position

描述(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、浮肿和疼痛的静脉性溃疡。这些溃疡的护理管理是 这是一个持续的挑战。常规护理干预措施包括使用加压绷带。 和频繁的腿部抬高。重要的是护士们要知道如何 压迫包扎和腿部抬高联合作用影响皮肤 微循环。这项修订后的新调查员提案的目标是 确定腿部/身体位置改变和加压包扎对 微血管反应性和功能的四个关键参数。具体的 目标是：具体目标1)测量基线(仰卧位)皮肤氧含量(02)，皮肤 二氧化碳(CO_2)、皮肤血液灌注量和肢体体积 静脉性溃疡患者和健康成人；特定目标2)测量皮肤 血氧饱和度、皮肤二氧化碳分压、皮肤血液灌注量和静脉血容量 溃疡患者和健康成人对腿部/身体位置变化的反应； 具体目标3)测量皮肤O2、皮肤C02、皮肤血液灌注量和四肢 静脉性溃疡患者和健康成人的下肢体积 对腿部/身体位置变化的反应，使用压缩绷带；特定目的 4)将激光多普勒流量估算的皮肤血流量与皮肤血流量进行相关分析。 经皮血氧饱和度测定仪对患者血液灌注量的评估 静脉性溃疡患者和健康成人对肢体变化的反应 在腿部/身体位置，有和没有压缩绷带。一种便利 收集静脉性溃疡和健康人的样本。科目 将在内侧测量皮肤O2、皮肤C02和皮肤血流灌注 仰卧、仰卧抬腿时的踝区和足部 300，还有站立。这些措施将重复进行，受试者将穿上 弹性压缩绷带。肢体体积将在基线1之后测量， 在定位方案之后，在基线2，在定位/压缩之后 协议，基线3之后。要回答目标1，将使用Hotellings T2。 为了回答目标2和目标3，将使用重复测量方差分析。回答目标 4、将执行关联。必须回答这些问题，以便 制定护理干预措施，规定最佳腿部/身体位置和 最大限度地促进愈合的按压组合。

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.