Department of Gerontological Nursing/Wound Care Management, The University of Tokyo, Tokyo, Japan.
J Wound Ostomy Continence Nurs. 2011 Jul-Aug;38(4):404-12. doi: 10.1097/WON.0b013e318220b6bc.
Pressure ulcer (PU) prevention is crucial for critically ill patients in the intensive care unit, but etiologic factors leading to their development have not yet been completely elucidated. This study explores the relationships among etiologic factors, interventional nursing care, and morphological characteristics of PUs in intensive care unit patients.
We used a qualitative exploratory method to link morphological characteristics of specific PUs to etiologic factors.
Details of individual PUs were described by sketching the PU photograph and categorized to characterize the morphology of PUs. After identification of characteristics, the development process was evaluated by in-depth review of medical records.
The morphological characteristics of 30 PUs were organized into 4 categories. This process revealed a type of PU not previously described, which we labeled "leaf-type." These PUs were located on the lower sacrum, rhombic-oval in shape, and characterized by purpura and PU wrinkles. Possible etiologic factors for the specific PUs were divided into 4 categories: (1) the occurrence of PU risk episodes, (2) failure of the peripheral circulation, (3) periods of critical immobility, and (4) position change techniques inducing skin deformation.
PU can be categorized into 4 morphological types, including a new category of leaf-shaped PU. We found that frequently repeated position changes such as lateral tilt and repeated head elevation caused deformation of the sacral skin that may play a role in PU development.
压疮（PU）预防对于重症监护病房的危重症患者至关重要，但导致其发生的病因因素尚未完全阐明。本研究探讨了病因因素、干预性护理以及重症监护病房患者压疮形态特征之间的关系。
我们使用定性探索方法将特定压疮的形态特征与病因因素联系起来。
通过对压疮照片进行素描来描述每个压疮的详细信息，并对压疮形态进行分类。在识别特征后，通过深入审查病历来评估发展过程。
30 个压疮的形态特征被分为 4 类。这一过程揭示了一种以前未描述过的压疮类型，我们将其标记为“叶型”。这些压疮位于骶骨下部，呈菱形-椭圆形，特征为紫癜和压疮皱纹。特定压疮的可能病因因素分为 4 类：（1）压疮风险事件的发生，（2）周围循环衰竭，（3）关键不动期，以及（4）导致皮肤变形的体位变化技术。
压疮可以分为 4 种形态类型，包括一种新的叶形压疮类别。我们发现，频繁重复的体位变化，如侧卧倾斜和反复抬头，可能导致骶部皮肤变形，这可能在压疮发展中起作用。
