Feldman D L, Sepka R S, Klitzman B
Plastic Surgery Research Laboratories, Duke University Medical Center, Durham, NC 27710-3906.
Ann Plast Surg. 1993 May;30(5):441-4. doi: 10.1097/00000637-199305000-00008.
Despite the widespread use of specialty bed products, the physiological mechanism of their benefit has not been evaluated. In this study, healthy subjects were used to study transcutaneous oxygen tension (TcPo2) and laser Doppler blood flow in pressure sore-prone areas on air-fluidized, low-air-loss, and adjustable air-mattress beds relative to a standard hospital mattress with and without an egg-crate mattress overlay. Measurements were obtained over the sacrum with the subject in the prone and supine positions, and over a greater trochanter with the subject in the prone and 90-degree lateral positions. Our results on healthy volunteers suggest that the specialty bed products maintain TcPo2 better than a standard bed when tissue is weighted. Further, the Clinitron had significantly higher TcPo2 when weighted than each of the other beds. Laser Doppler blood flow was much more variable. The weighted trochanter on the standard bed had the lowest blood flow, which is consistent with the TcPo2 readings. However, the variability made the laser Doppler flow data less valuable than the TcPo2. In conclusion, these data indicate that several products, particularly the Clinitron, maintain TcPo2 of weight-bearing tissue, which may be an important mechanism in protecting against pressure sores.
尽管专用床褥产品被广泛使用,但其有益效果的生理机制尚未得到评估。在本研究中,以健康受试者为对象,研究了在空气悬浮床、低气耗床和可调节气垫床上相对于带有和不带有蛋托床垫罩的标准医院床垫,压疮易发部位的经皮氧分压(TcPo2)和激光多普勒血流情况。在受试者俯卧位和仰卧位时于骶骨处进行测量,在受试者俯卧位和90度侧卧位时于大转子处进行测量。我们对健康志愿者的研究结果表明,当组织受压时,专用床褥产品比标准床能更好地维持TcPo2。此外,在受压时,Clinitron床的TcPo2显著高于其他各床。激光多普勒血流变化更大。标准床上受压的大转子处血流最低,这与TcPo2读数一致。然而,这种变异性使得激光多普勒血流数据不如TcPo2有价值。总之,这些数据表明,几种产品,特别是Clinitron床,能维持承重组织的TcPo2,这可能是预防压疮的一个重要机制。