PRESSURE ULCERS IN OLDER ADULTS--HEALING WITH TENS

老年人压疮——用十倍治愈

• 批准号: 3392834
• 负责人: Rita A Frantz
• 金额: $ 16.38万
• 依托单位: UNIVERSITY OF IOWA
• 依托单位国家: 美国
• 财政年份: 1992
• 资助国家: 美国
• 起止时间: 1992-09-30 至 1996-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3392834
• 关键词: United States; community health services; computer data analysis; health care service; histopathology; human middle age (35-64); human old age (65+); human subject; human therapy evaluation; image processing; mechanical pressure; rural area; skin ulcer; wound healing; wound infection

The purpose of this study is to determine the effectiveness of transcutaneous nerve stimulation (TENS) on healing of pressure ulcers in community-based older adults. Specifically, the study will aim to: (1) compare the rate of healing of pressure ulcers treated with conventional therapy and those treated with conventional therapy augmented with TENS, and (2) compare the rate of wound healing and the presence of specific patient variables and ulcer condition variables. The sample will consist of 40 subjects, 60 years of age and older, who have at least one pressure ulcer that has been resistant to healing for at least two months. Subjects will be obtained from a rural, midwest community-based dermatology clinic through referral from their attending physician and will be randomly assigned to one of two treatment groups. The experimental group will receive topical treatment to their ulcer consisting of course gauze dampened in normal saline and covered with a cotton filled dressing. In addition, their ulcer will be treated with TENS administered with electrodes applied to the ulcer edge three times a day for 30 minutes. The control group will receive the same topical treatment to their ulcer, but their TENS treatment will consist of "sham" TENS. Subjects will be followed for 8 weeks or until their ulcer heals. Rate of healing will be determined by weekly measurements of wound circumference, surface area, volume, depth and surface characteristics. Ulcer circumference, surface area, volume and depth will be measured with stereophotography, a method of remote three-dimensional measurement using stereoscopic pairs of photographs that are analyzed using a computerized image processor to calculate the desired measurements. Ulcer surface characteristics, including amount and quality of exudate and ulcer surface appearance, will be determined by direct observation and by photography. Specific patient variables will be assessed include: sex, age, medical history and medications, level of continence, mobility and activity, mental status, general physical status, level of oxygen supply to the ulcer, oxygen carrying capacity of the blood, immune competence and nutritional status. Ulcer condition variables will include documentation of: length of time the ulcer has been present, stage of the ulcer, presence of clinical indicators of wound infection and wound culture results. A group by time repeated measures analysis of variance will be used to examine differences in rate of healing between treatment groups. A Friedman two-way analysis of variance will be applied to determine differences in ulcer surface characteristics between the treatment groups. Within treatment groups, patient and ulcer condition variables will be correlated with differences in measures of rate of healing.

本研究的目的是确定 经皮神经刺激（TENS）对压疮愈合的影响 社区老年人。 具体而言，本研究旨在：（1） 比较传统治疗与传统治疗的压疮愈合率， 治疗和那些用TENS增强的常规治疗治疗的患者， 和（2）比较伤口愈合率和特定的 患者变量和溃疡状况变量。 样本将由40名受试者组成，60岁及以上， 至少有一个压力性溃疡，一直难以愈合， 至少两个月 受试者将来自中西部的农村， 社区皮肤科诊所，由其主治医生转诊 医生，并将随机分配到两个治疗组之一。 实验组将接受局部治疗他们的溃疡 包括用生理盐水浸湿的纱布， 棉填充敷料。 此外，他们的溃疡将得到治疗， 经皮神经电刺激（TENS），将电极施加到溃疡边缘三次 每天30分钟。 对照组将接受相同的主题 治疗他们的溃疡，但他们的TENS治疗将包括 "假"十个。 将对受试者进行8周随访或直至其溃疡 治愈 愈合率将通过每周测量伤口来确定 周长、表面积、体积、深度和表面特征。 将测量溃疡周长、表面积、体积和深度 利用立体摄影术，一种远程三维测量的方法 使用立体照片对，这些照片使用 计算机化的图像处理器来计算所需的测量。 溃疡表面特征，包括渗出物的量和质量 和溃疡表面外观，将通过直接观察确定 and by photography摄影. 将评估的具体患者变量包括：性别、年龄、医疗 病史和药物治疗，糖尿病水平，活动能力和活动， 精神状态，一般身体状况，氧气供应水平， 溃疡、血液携氧能力、免疫能力和 营养状况 溃疡状况变量将包括 记录：溃疡存在的时间长度，阶段 溃疡、存在伤口感染和伤口的临床指标 文化成果。 将使用按时间重复测量的分组方差分析， 检查治疗组之间愈合率的差异。 一 将应用Friedman双向方差分析来确定 治疗组之间溃疡表面特征的差异 组 在治疗组内，患者和溃疡状况变量 将与愈合率的测量差异相关。