Kumagai Ayumi, Ohno Naoki, Miyati Tosiaki, Okuwa Mayumi, Nakatani Toshio, Sanada Hiromi, Sugama Junko
Graduate Course of Nursing Science, Division of Health Sciences Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Ishikawa, Japan.
Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Ishikawa, Japan.
J Tissue Viability. 2019 Feb;28(1):14-20. doi: 10.1016/j.jtv.2018.10.007. Epub 2018 Nov 22.
In operating rooms, the occurrence of pressure ulcers caused by being in the prone position is the highest among that of pressure ulcers caused by being in other surgical positions. Thus, we investigated effects of hardness and shape of urethane foam mattresses for preventing pressure ulcers during surgery performed with patients in the prone position. We aimed to elucidate how mattresses of variable hardness and shapes affect compression and displacement of the skin and soft tissues with external force in the prone position.
We assessed effects of two shapes [rectangular cube (RC) and trapezoid cube (TC)] and four degrees of hardness (50, 87.5, 175, and 262.5 N) in each shape. We performed magnetic resonance imaging (MRI) of the iliac crests with external force while participants reclined in the prone position on eight different mattresses.
Compression of the skin and soft tissue was significantly higher with 87.5-, 175-, and 262.5-N mattresses than that with 50-N mattresses. Skin and soft tissue displacement was higher with TC mattress than that with RC mattress, and the extent of skin surface and internal soft tissue displacement was different.
Compression of the skin and soft tissue depends on mattress hardness; however, a threshold value (175 N) for hardness exists, above which no further changes in the parameters were observed. Skin and soft tissue displacement does not depend on mattress hardness, but rather on its shape. Furthermore, mattress inclination increases skin surface displacement.
在手术室中，俯卧位导致的压疮发生率高于其他手术体位导致的压疮发生率。因此，我们研究了聚氨酯泡沫床垫的硬度和形状对俯卧位手术患者预防压疮的效果。我们旨在阐明不同硬度和形状的床垫在俯卧位时外力作用下如何影响皮肤和软组织的压缩及位移。
我们评估了两种形状[长方体（RC）和梯形体（TC）]以及每种形状的四种硬度程度（50、87.5、175和262.5 N）的效果。当参与者俯卧在八种不同床垫上时，我们在外力作用下对髂嵴进行磁共振成像（MRI）。
87.5 N、175 N和262.5 N床垫对皮肤和软组织的压缩明显高于50 N床垫。TC床垫导致的皮肤和软组织位移高于RC床垫，且皮肤表面和内部软组织位移程度不同。
皮肤和软组织的压缩取决于床垫硬度；然而，存在一个硬度阈值（175 N），超过该阈值参数未见进一步变化。皮肤和软组织位移不取决于床垫硬度，而是取决于其形状。此外，床垫倾斜会增加皮肤表面位移。
