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Nursing Science 2025
预防压疮的研究进展
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Abstract:
压疮被认为在很大程度上是一个可预防的问题，然而，尽管开展了广泛培训并投入了大量资源，压疮问题依然存在。本文回顾了目前对压疮病因的认识，即压力、剪切应力和微环境。为了确定个体的风险水平，还需要了解发生压疮的个体风险因素。这种评估对于确定恰当的预防策略至关重要。本文研究了在减轻压力和剪切力以及控制微环境方面的主要预防策略。此外，本文也探讨了由于大多数标准预防策略对于预防医疗器械相关的压疮无效这一问题。
Pressure ulcers are considered to be a largely preventable problem, however, despite extensive training and significant resources invested, the problem persists. This article reviews the current understanding of the causes of pressure ulcers, namely, pressure, shear stress, and microenvironment. In order to determine an individual’s level of risk, it is also necessary to understand the individual risk factors for developing pressure ulcers. This assessment is essential to determine appropriate prevention strategies. This paper examines the main prevention strategies in terms of reducing stress and shear forces and controlling the microenvironment. In addition, this paper explores the ineffectiveness of most standard prevention strategies for preventing pressure ulcers associated with medical devices.
| [1] | Prentice, J.L., Stacey, M.C. and Lewin, G. (2003) An Australian Model for Conducting Pressure Ulcer Prevalence Surveys. Primary Intention, 11, 87-109. |
| [2] | Van Gilder, C., Amlung, S., Harrison, P. and Meyer, S. (2009) Results of the 2008-2009 International Pressure Ulcer Prevalence™ Survey and a 3-Year, Acute Care, Unit-Specific Analysis. Ostomy Wound Manage, 55, 39-45. |
| [3] | Kottner, J., Wilborn, D., Dassen, T. and Lahmann, N. (2009) The Trend of Pressure Ulcer Prevalence Rates in German Hospitals: Results of Seven Cross-Sectional Studies. Journal of Tissue Viability, 18, 36-46. https://doi.org/10.1016/j.jtv.2009.02.002 |
| [4] | Harrison, M.B., Mackey, M. and Friedberg, E. (2008) Pressure Ulcer Monitoring: A Process of Evidence-Based Practice, Quality, and Research. The Joint Commission Journal on Quality and Patient Safety, 34, 355-359. https://doi.org/10.1016/s1553-7250(08)34045-8 |
| [5] | NPUAP/EPUAP (2023) Prevention and Treatment of Pressure Ulcers: Clinical Practice Guideline. NPUAP. |
| [6] | Reswick, J.B. and Rogers, J.E. (1976) Experience at Rancho Los Amigos Hospital with Devices and Techniques to Prevent Pressure Sores. In: Kenedi, R.M. and Cowden, J.M., Eds., Bed Sore Biomechanics, Macmillan Education UK, 301-310. https://doi.org/10.1007/978-1-349-02492-6_38 |
| [7] | Gefen, A., van Nierop, B., Bader, D.L. and Oomens, C.W. (2008) Strain-Time Cell-Death Threshold for Skeletal Muscle in a Tissue-Engineered Model System for Deep Tissue Injury. Journal of Biomechanics, 41, 2003-2012. https://doi.org/10.1016/j.jbiomech.2008.03.039 |
| [8] | Takahashi, M., Black, J., Dealey, C. and Gefen, A. (2023) Pressure in Context. International Review: Pressure Ulcer Prevention: Pressure, Shear, Friction and Microclimate in Context, 52, 20-12. |
| [9] | Reger, S.I., Ranganathan, V.K., Orsted, H.L., Ohura, T. and Gefen, A. (2010) Shear and Friction in Context. International Review: Pressure Ulcer Prevention: Pressure, Shear, Friction and Microclimate, 45, 43-56. |
| [10] | Clark, M., Romanelli, M., Reger, S.I., Ranganathan, V.K., Black, J. and Dealey, C. (2010) Microclimate in Context. In: Baharestani, M., et al., Eds., International Review: Pressure Ulcer Prevention: Pressure, Shear, Friction and Microclimate, 75, 22-87. |
| [11] | Bergstrom, N. and Braden, B. (1992) A Prospective Study of Pressure Sore Risk among Institutionalized Elderly. Journal of the American Geriatrics Society, 40, 747-758. https://doi.org/10.1111/j.1532-5415.1992.tb01845.x |
| [12] | Nixon, J., Brown, J., McElvenny, D., Mason, S. and Bond, S. (2000) Prognostic Factors Associated with Pressure Sore Development in the Immediate Post-Operative Period. International Journal of Nursing Studies, 37, 279-289. https://doi.org/10.1016/s0020-7489(99)00059-0 |
| [13] | Fisher, S.V., Szymke, T.E., Apte, S.Y. and Kosiak, M. (1978) Wheelchair Cushion Effect on Skin Temperature. Archives of Physical Medicine and Rehabilitation, 59, 68-72. |
| [14] | Coleman, S., Gorecki, C., Nelson, E.A., Closs, S.J., Defloor, T., Halfens, R., et al. (2013) Patient Risk Factors for Pressure Ulcer Development: Systematic Review. International Journal of Nursing Studies, 50, 974-1003. https://doi.org/10.1016/j.ijnurstu.2012.11.019 |
| [15] | National Pressure Ulcer Advisory Panel (2007) Support Surface Standards Initiative-Terms and Definitions Related to Support Surfaces. NPUAP. |
| [16] | Defloor, T. and Grypdonck, M.H.F. (1999) Sitting Posture and Prevention of Pressure Ulcers. Applied Nursing Research, 12, 136-142. https://doi.org/10.1016/s0897-1897(99)80045-7 |
| [17] | Stockton, L. and Flynn, M. (2009) Sitting and Pressure Ulcers 1: Risk Factors, Self Repositioning and Other Interventions. Nursing Times, 105, 12-14. |
| [18] | Buss, I.C., Halfens, R.J.G. and Abu-Saad, H.H. (1997) The Effectiveness of Massage in Preventing Pressure Sores: A Literature Review. Rehabilitation Nursing, 22, 229-234. https://doi.org/10.1002/j.2048-7940.1997.tb02107.x |
| [19] | Torra i Bou, J., Segovia Gómez, T., Verdú Soriano, J., Nolasco Bonmatí, A., Rueda López, J. and Arboix i Perejamo, M. (2005) The Effectiveness of a Hyper-Oxygenated Fatty Acid Compound in Preventing Pressure Ulcers. Journal of Wound Care, 14, 117-121. https://doi.org/10.12968/jowc.2005.14.3.26752 |
| [20] | Clever, K., Smith, G., Bowser, C. and Monroe, K. (2002) Evaluating the Efficacy of a Uniquely Delivered Skin Protectant and Its Effect on the Formation of Sacral/Buttock Pressure Ulcer. Ostomy Wound Management, 48, 60-67. |
| [21] | Beeckman, D., Schoonhoven, L., Verhaeghe, S., Heyneman, A. and Defloor, T. (2009) Prevention and Treatment of Incontinence‐Associated Dermatitis: Literature Review. Journal of Advanced Nursing, 65, 1141-1154. https://doi.org/10.1111/j.1365-2648.2009.04986.x |
| [22] | Fader, M., Cottenden, A., Getliffe, K., Gage, H., Clarke-O’Neill, S., Jamieson, K., et al. (2008) Absorbent Products for Urinary/Faecal Incontinence: A Comparative Evaluation of Key Product Designs. Health Technology Assessment, 12, 1-130. https://doi.org/10.3310/hta12290 |
| [23] | Kottner, J. and Blume-Peytavi, U. (2021) Reliability and Agreement of Instrumental Skin Barrier Measurements in Clinical Pressure Ulcer Prevention Research. International Wound Journal, 18, 716-727. https://doi.org/10.1111/iwj.13574 |
