Blaylock B
Ostomy Wound Manage. 1996 May;42(4):26-8, 30, 32-3.
Cervical orthotic devices (cervical collars) are integral to the treatment of patients with suspected or confirmed fracture of the cervical spine. Pressure ulcers can develop under the cervical collar on the occipital protuberance and on the chin due to both prolonged immobilization and the collar construction. A multidisciplinary team at a Northwest Ohio trauma center led an investigation of this problem when a one day study of pressure ulcer prevalence revealed that of 4% of nosocomial pressure ulcers, 2% were attributed to cervical collars. To solve this problem, the team visualized risk factors using a fishbone diagram, investigated by calling manufacturers and other institutions and by searching the literature, developed educational programs on skin care and correct collar fitting, conducted a product trial on a new collar, and continuously monitored the results. The conclusions of the team were that the pressure ulcers were the result of the construction of the previous cervical collars used. The product trial resulted in zero skin breakdown for the 20 patients involved. Changes implemented as a result were an improved skin care regimen, education on proper fitting and appropriate choice of collars, and implementation of the new collar for trauma patients.
颈椎矫形器械（颈托）对于疑似或确诊颈椎骨折患者的治疗至关重要。由于长期固定以及颈托的构造，在颈托下方的枕骨隆突和下巴处可能会形成压疮。俄亥俄州西北部一家创伤中心的多学科团队对这一问题展开了调查，当时一项关于压疮患病率的为期一天的研究显示，在医院获得性压疮中，有4%是由颈托导致的，其中2%归因于颈托。为了解决这个问题，该团队使用鱼骨图直观呈现风险因素，通过联系制造商和其他机构以及查阅文献进行调查，制定了皮肤护理和正确佩戴颈托的教育项目，对一种新颈托进行了产品试用，并持续监测结果。该团队得出的结论是，压疮是此前使用的颈托构造所致。产品试用中，参与的20名患者均未出现皮肤破损情况。由此实施的改进措施包括优化皮肤护理方案、开展关于正确佩戴和合适颈托选择的教育，以及为创伤患者采用新颈托。
