PRESSURE ULCERS IN OLDER ADULTS--HEALING WITH TENS

这项研究的目的是确定联合治疗的有效性 经皮神经电刺激(TENS)对压疮愈合的影响 以社区为基础的老年人。具体来说，这项研究的目标是：(1) 传统疗法治疗压疮的愈合率比较 治疗和常规治疗加用TENS的患者， 以及(2)比较创面愈合率和特异度。 患者变量和溃疡情况变量。 样本将包括40名60岁及以上的受试者，他们 至少有一个压疮不能痊愈 至少两个月。受试者将从中西部的农村地区获得 通过主治医生转诊的社区皮肤科诊所 并将被随机分配到两个治疗组中的一个。 试验组将接受溃疡的局部治疗。 当然包括用生理盐水浸湿的纱布，上面覆盖着 填充棉的敷料。此外，他们的溃疡将得到治疗 在溃疡边缘使用电极三次给药 一天30分钟。对照组将收到相同的主题 治疗他们的溃疡，但他们的TENS治疗将包括 “假的”十元。受试者将被跟踪8周或直到他们的溃疡 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，一种远程三维测量的方法 使用立体照片对，这些照片是使用 计算机化的图像处理器，用于计算所需的测量结果。 溃疡表面特征，包括渗出物的数量和质量 和溃疡表面的外观，将由直接观察确定 并通过摄影。 具体的患者变量将被评估，包括：性别、年龄、医疗 病史和用药情况，大小便控制程度，活动度和活动量， 精神状态，一般身体状况，供氧水平 溃疡，血液的携氧能力，免疫能力和 营养状况。溃疡情况变量将包括 记录：溃疡出现的时间长度，阶段 溃疡，存在伤口感染和伤口的临床指标 培养结果。 按时间分组重复测量的方差分析将被用于 检查治疗组之间治愈率的差异。一个 弗里德曼双因素方差分析用于确定 不同治疗方法对溃疡表面特征的影响 组。在治疗组内，患者和溃疡状况变量 将与治愈率的衡量标准的差异相关。

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.