Department of Clinical Nursing, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 5-11-80 Kotatsuno, Kanazawa 920-0942, Japan.
J Tissue Viability. 2011 May;20(2):55-66. doi: 10.1016/j.jtv.2010.12.002. Epub 2011 Feb 2.
Pressure ulcers are a common problem, especially in older patients. In Japan, most institutionalized older people are malnourished and show extreme bony prominence (EBP). EBP is a significant factor in the development of pressure ulcers due to increased interface pressure concentrated at the skin surface over the EBP. The use of support surfaces is recommended for the prophylaxis of pressure ulcers. However, the present equivocal criteria for evaluating the pressure redistribution of support surfaces are inadequate. Since pressure redistribution is influenced by physique and posture, evaluations using human subjects are limited. For this reason, models that can substitute for humans are necessary. We developed a new EBP model based on the anthropometric measurements, including pelvic inclination, of 100 bedridden elderly people. A comparison between the pressure distribution charts of our model and bedridden elderly subjects demonstrated that maximum contact pressure values, buttock contact pressure values, and bone prominence rates corresponded closely. This indicates that the model provides a good approximation of the features of elderly people with EBP. We subsequently examined the validity of the model through quantitative assessment of pressure redistribution functions consisting of immersion, envelopment, and contact area change. The model was able to detect differences in the hardness of urethane foam, differences in the internal pressure of an air mattress, and sequential changes during the pressure switching mode. These results demonstrate the validity of our new buttock model in evaluating pressure redistribution for a variety of surfaces.
压疮是一个常见的问题，特别是在老年患者中。在日本，大多数机构化的老年人都存在营养不良和极度骨性突出（EBP）的情况。由于 EBP 处的皮肤表面集中了增加的界面压力，EBP 是压疮发展的一个重要因素。使用支撑面是预防压疮的推荐方法。然而，目前评估支撑面压力重新分布的标准存在不确定性。由于压力重新分布受到体型和姿势的影响，使用人体进行评估受到限制。因此，需要能够替代人体的模型。我们根据 100 名卧床老年人的人体测量学，包括骨盆倾斜度，开发了一种新的 EBP 模型。我们的模型与卧床老年人的压力分布图表进行了比较，结果表明最大接触压力值、臀部接触压力值和骨性突出率非常接近。这表明该模型很好地模拟了 EBP 老年患者的特征。随后，我们通过定量评估包括浸入、包裹和接触面积变化的压力重新分布功能来检验模型的有效性。该模型能够检测出不同的聚氨酯泡沫硬度、不同的气垫内部压力以及压力切换模式下的连续变化。这些结果证明了我们新的臀部模型在评估各种表面压力重新分布方面的有效性。
