Berke Christine Thies
Christine Thies Berke, MSN, APRN-NP, CWOCN-AP, AGPCNP-BC, The Nebraska Medical Center, Center for Wound Healing, Omaha.
J Wound Ostomy Continence Nurs. 2015 Jan-Feb;42(1):47-61. doi: 10.1097/WON.0000000000000087.
Effective wound management is dependent, in part, on identification and correction of causative factors. Trunk wounds can be caused by pressure, shear, moisture, friction, or some combination of these factors. Wounds caused by moisture and/or friction are frequently mislabeled as pressure ulcers.
This article presents a series of 45 patients who developed skin injuries on the medial buttocks and/or posterior thighs that the author believes were caused primarily by friction damage to the skin. The lesions were not located over palpable bony prominences and are therefore unlikely to be pressure ulcers. They were not located in skin folds and are unlikely to represent intertriginous dermatitis. Clinical data related to these 45 patients are presented, as are the location and characteristics of the lesions. These characteristics are discussed in relation to current literature regarding the pathology and clinical presentation of wounds caused by pressure, moisture, and friction.
It is critical for wound clinicians and staff nurses to accurately identify the etiology of any wound. Wounds located on fleshy prominences exposed to repetitive friction should be labeled as friction injuries.
有效的伤口管理部分取决于对病因的识别和纠正。躯干伤口可能由压力、剪切力、潮湿、摩擦或这些因素的某种组合引起。由潮湿和/或摩擦导致的伤口常被错误地归类为压疮。
本文介绍了45例在内侧臀部和/或大腿后侧出现皮肤损伤的患者，作者认为这些损伤主要是由皮肤摩擦损伤引起的。这些损伤并非位于可触及的骨性突出部位，因此不太可能是压疮。它们也不在皮肤褶皱处，不太可能是间擦疹。文中呈现了与这45例患者相关的临床数据，以及损伤的位置和特征。结合当前关于由压力、潮湿和摩擦导致伤口的病理及临床表现的文献，对这些特征进行了讨论。
对于伤口临床医生和护士来说，准确识别任何伤口的病因至关重要。位于暴露于反复摩擦的肉质突出部位的伤口应被归类为摩擦损伤。
