Mizokami Fumihiro, Takahashi Yoshiko, Nemoto Tetsuya, Nagai Yayoi, Tanaka Makiko, Utani Atsushi, Furuta Katsunori, Isogai Zenzo
Department of Pharmacy, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan.
Department of Nursing & Health, School of Nursing & Health, Aichi Prefectural University, Nagoya, Aichi, Japan.
J Tissue Viability. 2015 Feb;24(1):35-40. doi: 10.1016/j.jtv.2015.01.002. Epub 2015 Jan 29.
A pressure ulcer is defined as damage to skin and other tissues over a bony prominence caused by excess pressure. Deep pressure ulcers that develop over specific bony prominences often exhibit wound deformity, defined as a change in the 3-dimensional shape of the wound. Subsequently, the wound deformity can result in undermining formation, which is a characteristic of deep pressure ulcers. However, to date, a concept with respect to alleviating wound deformity has yet to be defined and described. To clarify the issue, we propose a new concept called "wound fixation" based on the physical properties of deep pressure ulcers with wound deformity. Wound fixation is defined here as the alleviation of wound deformity by exogenous materials. The wound fixation methods are classified as traction, anchor, and insertion based on the relation between the wound and action point by the exogenous materials. A retrospective survey of a case series showed that wound fixation was preferentially used for deep pressure ulcers at specific locations such as the sacrum, coccyx, and greater trochanter. Moreover, the methods of wound fixation were dependent on the pressure ulcer location. In conclusion, our new concept of wound fixation will be useful for the practical treatment and care of pressure ulcers. Further discussion and validation by other experts will be required to establish this concept.
压疮被定义为因压力过大导致骨隆突处皮肤和其他组织受损。在特定骨隆突处形成的深度压疮常表现出伤口畸形，即伤口三维形状的改变。随后，伤口畸形会导致潜行形成，这是深度压疮的一个特征。然而，迄今为止，关于减轻伤口畸形的概念尚未得到定义和描述。为了阐明这一问题，我们基于有伤口畸形的深度压疮的物理特性，提出了一个名为“伤口固定”的新概念。此处伤口固定定义为通过外源性材料减轻伤口畸形。根据外源性材料与伤口的作用点关系，伤口固定方法分为牵引、锚定和插入三类。对一组病例的回顾性调查显示，伤口固定优先用于骶骨、尾骨和大转子等特定部位的深度压疮。此外，伤口固定方法取决于压疮位置。总之，我们的伤口固定新概念将有助于压疮的实际治疗和护理。要确立这一概念，还需要其他专家进行进一步的讨论和验证。
