Robles-Romero José Miguel, Romero-Martín Macarena, Conde-Guillén Gloria, Cruces-Romero Daniel, Gómez-Salgado Juan, Ponce-Blandón José Antonio
Faculty of Nursing, Department of Nursing, University of Huelva, 21071 Huelva, Spain.
Cruz Roja University Nursing School, University of Seville, 41009 Seville, Spain.
Healthcare (Basel). 2020 May 28;8(2):147. doi: 10.3390/healthcare8020147.
The high incidence of vascular ulcers and the difficulties encountered in their healing process require the understanding of their multiple etiologies to develop effective strategies focused on providing different treatment options. This work provides a description of the principles of the physics of fluid dynamics related to vascular ulcers. The morphological characteristics of the cardiovascular system promote blood flow. The contraction force of the left ventricle is enhanced by its ability to reduce its radius of curvature and by increasing the thickness of the ventricular wall (Laplace's Law). Arterial flow must overcome vascular resistance (Ohm's equation). The elastic nature of the artery and the ability to reduce its diameter as flow rate progresses facilitate blood conduction at high speed up to arteriolar level, and this can be determined by the second equation of continuity. As it is a viscous fluid, we must discuss laminar flow, calculated by the Reynolds number, which favors proper conduction while aiming at the correct net filtration pressure. Any endothelial harmful process that affects the muscle wall of the vessel increases the flow speed, causing a decrease in capillary hydrostatic pressure, thus reducing the exchange of nutrients at the interstitial level. With regard to the return system, the flow direction is anti-gravity and requires endogenous aid to establish the Starling's equilibrium. Knowledge on the physics of vascular fluid dynamics makes it easier to understand the processes of formation of these ulcers so as to choosing the optimal healing and prevention techniques for these chronic wounds.
血管溃疡的高发病率及其愈合过程中遇到的困难,需要了解其多种病因,以制定侧重于提供不同治疗选择的有效策略。这项工作描述了与血管溃疡相关的流体动力学物理原理。心血管系统的形态特征促进血液流动。左心室的收缩力通过其减小曲率半径的能力和增加心室壁厚度(拉普拉斯定律)而增强。动脉血流必须克服血管阻力(欧姆方程)。动脉的弹性性质以及随着流速增加而减小其直径的能力有助于血液高速传导至小动脉水平,这可以由连续性第二方程确定。由于血液是粘性流体,我们必须讨论由雷诺数计算的层流,层流有利于正常传导,同时针对正确的净滤过压。任何影响血管肌壁的内皮有害过程都会增加流速,导致毛细血管静水压降低,从而减少间质水平的营养物质交换。关于回流系统,血流方向是反重力的,需要内源性辅助来建立斯塔林平衡。了解血管流体动力学物理知识有助于更容易理解这些溃疡的形成过程,从而为这些慢性伤口选择最佳的愈合和预防技术。