Daniel R K, Hall E J, MacLeod M K
Ann Plast Surg. 1979 Jul;3(1):53-63.
Pressure sores are a common problem. They are casually accepted, their etiology is well defined, and treatment is standardized. How, therefore, can the subject justify reappraisal? On detailed review, evidence is presented showing that pressure sores can be minimized, that their pathophysiology is far from certain, and that their management is changing dramatically. During the past decade, new preventive measures have been adopted consisting of multidisciplinary tissue trauma clinics for paraplegic patients, based in rehabilitation hospitals, as well as early identification of the "at-risk" subgroup of geriatric patients who will require aggressive nursing care. Although pressure is the most widely accepted etiological factor, no sophisticated experimental studies have corroborated this hypothesis, and in fact, the majority of research conflicts with clinical observations. Recently, new surgical proceudres-myocutaneous and sensory skin flaps-have been devised to solve complex coverage problems which will possibly reduce the recurrence rate. An in-depth review of pressure sores is therefore warranted and will, we hope, stimulate renewed interest in this all-too-frequent clinical affliction.
压疮是一个常见问题。人们对此习以为常，其病因已明确界定，治疗方法也已标准化。那么，这个主题为何还要重新评估呢？经过详细审查，有证据表明压疮可以减至最少，其病理生理学远未确定，且其管理正在发生巨大变化。在过去十年中，已采取了新的预防措施，包括在康复医院为截瘫患者设立多学科组织创伤诊所，以及尽早识别需要积极护理的老年“高危”亚组患者。尽管压力是最被广泛认可的病因，但尚无复杂的实验研究证实这一假设，事实上，大多数研究与临床观察结果相矛盾。最近，已经设计出了新的外科手术——肌皮瓣和感觉皮瓣——来解决复杂的覆盖问题，这可能会降低复发率。因此，有必要对压疮进行深入审查，我们希望这将激发人们对这种极其常见的临床疾病重新产生兴趣。
