School of Nursing, San Jose State University, California, USA.
Adv Skin Wound Care. 2011 Dec;24(12):562-70. doi: 10.1097/01.ASW.0000408466.88880.f8.
The aim of the study was to examine the effect of external pressure of the bed surface on heel skin temperature in adults in the first 3 days after hip surgery.
A quasi-experimental study in a prospective, within-subjects, repeated-measures design.
This study was performed at 2 acute-care hospitals.
Eighteen subjects (9 men and 9 women) with a mean age of 58.3 (±16.1) years were recruited after hip surgery at the 2 hospitals.
Temperature sensors were placed on the plantar surface of each foot, close to the heels. Measures were taken when the heels were (1) suspended above the bed surface for 20 minutes (preload), (2) on the bed surface for 15 minutes (loading), and (3) suspended again above the bed surface for 15 minutes (unloading).
Heel skin temperature and demographic data.
Heel temperature increased during loading and unloading in both legs on postoperative days 1 (P = .003) and 3 (P = .04) but not on postoperative day 2. Heel temperature in the nonoperative leg decreased in the first 3 minutes of unloading on postoperative days 2 (P = .02) and 3 (P = .01).
Heel temperature increased with loading and unloading on postoperative days 1 and 3. Upon immediate unloading, hyperemic response was present only in the nonoperative leg. Keeping the heels off the bed surface at all times may avoid heel skin temperature changes and prevent tissue damage. Further research is needed to identify the mechanisms that explain the effect of external pressure on heel temperature.
本研究旨在探讨髋关节手术后第 1 至 3 天，床面外部压力对成人足跟皮肤温度的影响。
前瞻性、自身对照、重复测量的准实验研究。
本研究在 2 家急性护理医院进行。
从 2 家医院招募了 18 名受试者（9 名男性和 9 名女性），平均年龄为 58.3（±16.1）岁，均接受髋关节手术后。
在每个足部的足底表面靠近足跟处放置温度传感器。测量时，足跟（1）悬空于床面上方 20 分钟（预加载），（2）置于床面上方 15 分钟（加载），（3）再次悬空于床面上方 15 分钟（卸载）。
足跟皮肤温度和人口统计学数据。
术后第 1 天（P =.003）和第 3 天（P =.04），双侧足跟在加载和卸载过程中温度升高，但术后第 2 天无变化。术后第 2 天和第 3 天，非手术侧足跟在卸载的最初 3 分钟内温度下降（P =.02 和 P =.01）。
术后第 1 天和第 3 天，足跟在加载和卸载过程中温度升高。即刻卸载时，仅非手术侧下肢出现充血反应。足跟始终不接触床面可能避免足跟皮肤温度变化并预防组织损伤。需要进一步研究以确定解释外部压力对足跟温度影响的机制。
