Huber Jacqueline, Reddy Raj, Pitham Tom, Huber David
Prince Alfred Hospital, Sydney, New South Wales, Australia.
Adv Skin Wound Care. 2008 Jan;21(1):37-41. doi: 10.1097/01.ASW.0000284968.07982.26.
To determine the efficacy of elevation in the primary prevention and treatment of pressure ulcers by studying the blood flow in tissue at risk of ulceration.
A prospective study was used to compare different preventative devices with an elevating prosthesis.
: Wollongong Hospital Wollongong, New South Wales, Australia.
Normal subjects and subjects with vasculopathy were tested with their heel resting on a hospital bed, medical-grade lamb's wool, or a viscoelastic gel overlay, with or without the test prosthesis. Skin perfusion was measured throughout using a laser Doppler monitor.
A device designed to elevate the heel off the bed and distribute the weight of the leg and foot on the calf.
Heel capillary blood perfusion.
Perfusion in the heel was significantly greater when elevated than when using the other devices tested. The differences in mean red blood cell flux were significant, with P < .0001 for bed-normals, ie, subjects with no peripheral vascular disease on an alpha Xcell mattress overlay as the control with flux increasing from 7.6 to 163.1 arbitrary units (AU); P < .005 bed-vasculopathy, ie, subjects with peripheral vascular disease on an alpha Xcell mattress overlay as the control with flux increasing from 31.6 to 224.7 AU; P < .0001 viscoelastic overlay subjects where the viscoelastic overlay was the control with flux increasing from 26.6 to 291.4 AU; and P < .01 lamb's wool subjects where the lamb's wool was the control with flux increasing from 27.7 AU to 169.2 AU.
In this study, when the heels were elevated, tissue perfusion to that area was substantially increased. When the heel was transferred to the elevating splint, the heel capillary bed underwent reactive hyperemia, indicating the alleviation of tissue hypoxia. Elevation is therefore an important technique in pressure ulcer prevention and treatment and should be incorporated into health care practice.
通过研究溃疡形成风险组织中的血流情况，确定抬高足跟在预防和治疗压疮中的有效性。
采用前瞻性研究，将不同的预防装置与一种抬高足跟的假体进行比较。
澳大利亚新南威尔士州卧龙岗市卧龙岗医院。
正常受试者和血管病变受试者，让他们的足跟分别置于医院病床、医用级羊毛垫或粘弹性凝胶垫上，有或没有测试假体。全程使用激光多普勒监测仪测量皮肤灌注情况。
一种设计用于将足跟抬离床面并将腿部和足部重量分散到小腿的装置。
足跟毛细血管血液灌注。
足跟抬高时的灌注明显高于使用其他测试装置时。平均红细胞通量差异显著，以α Xcell床垫作为对照，无外周血管疾病的正常受试者（床 - 正常组）通量从7.6任意单位（AU）增加到163.1 AU，P <.0001；外周血管疾病受试者（床 - 血管病变组）通量从31.6 AU增加到224.7 AU，P <.005；以粘弹性凝胶垫作为对照的粘弹性凝胶垫组受试者通量从26.6 AU增加到291.4 AU，P <.0001；以羊毛垫作为对照的羊毛垫组受试者通量从27.7 AU增加到169.2 AU，P <.01。
在本研究中，足跟抬高时该区域的组织灌注显著增加。当足跟转移到抬高夹板上时，足跟毛细血管床出现反应性充血，表明组织缺氧得到缓解。因此，抬高足跟是预防和治疗压疮的一项重要技术，应纳入医疗保健实践中。
