• 대한인간공학회지
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• 제29권6호
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• pp.875-887
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• 2010

The quantitative effectiveness of powered support surfaces such as APAM in preventing and treating pressure ulcers has not been sufficiently evaluated because of uncertainty of alternating pressure load input and lack of interpretation of dynamic perfusion characteristics of soft tissue. The aim was to verify the dynamic loading effects to sacral tissue perfusion characteristics from alternating set pressure changes. We developed integrated experiment system to supply alternating load to supinely positioned sacrum and concurrently measured $TcPO_2$, $TcPCO_2$ and air cell pressure. Ten aged subjects (5 female, 5 male) were tested with alternating set pressure 20, 30, 40, 50 and 60mmHg. From the dynamic perfusion response eight characteristic parameters were proposed such as average, minimum, maximum and perfusion range regarding to $TcPO_2$ and $TcPCO_2$. A one-way ANOVA was carried out to determine whether the manipulation of alternating set pressure had any effect on $TcPO_2$ and $TcPCO_2$. From the dynamic tissue perfusion response we found mean $TcPO_2$ decreased exponentially as alternating pressure load increased and perfusion range varied mainly because of minimum level change of $TcPO_2$. And perfusion range of $TcPCO_2$ affected by increase of maximum value of $TcPCO_2$. From the results we can get more strict insights about actual physiological dynamic tissue perfusion mechanism under alternating pressure load.

• 기본간호학회지
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• 제23권3호
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• pp.256-263
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• 2016

Purpose: This study was done to examine the prophylactic effect of transparent film dressing on the sacrum and coccyx sites to reduce pressure ulcers. Methods: The participants were 317 patients admitted to an SICU in Seoul, Korea. Of the patients, 175 were assigned to the experimental group and 142 to the control group. For participants in the experimental group, a prophylactic transparent film dressing was applied on the sacrum and coccyx. The control group received the usual care. The nurses checked for pressure ulcers on the sacrum and coccyx at least once every duty. When pressure ulcer occurred, it reported on the record form. The results were analyzed using Poisson and Hierarchical logistic regression. Results: The prevalence and risk of pressure ulcer was lower in the experimental group compared to the control group but the difference was not significant. The ICU length of stay was significantly associated with pressure ulcer risk. Conclusion: Findings indicate that prophylactic transparent film dressing helps to reduce pressure ulcer in SICU patients.

• 대한간호학회지
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• 제49권5호
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• pp.575-585
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• 2019

Purpose: The purpose of this study was to develop predictive models for pressure ulcer incidence using electronic health record (EHR) data and to compare their predictive validity performance indicators with that of the Braden Scale used in the study hospital. Methods: A retrospective case-control study was conducted in a tertiary teaching hospital in Korea. Data of 202 pressure ulcer patients and 14,705 non-pressure ulcer patients admitted between January 2015 and May 2016 were extracted from the EHRs. Three predictive models for pressure ulcer incidence were developed using logistic regression, Cox proportional hazards regression, and decision tree modeling. The predictive validity performance indicators of the three models were compared with those of the Braden Scale. Results: The logistic regression model was most efficient with a high area under the receiver operating characteristics curve (AUC) estimate of 0.97, followed by the decision tree model (AUC 0.95), Cox proportional hazards regression model (AUC 0.95), and the Braden Scale (AUC 0.82). Decreased mobility was the most significant factor in the logistic regression and Cox proportional hazards models, and the endotracheal tube was the most important factor in the decision tree model. Conclusion: Predictive validity performance indicators of the Braden Scale were lower than those of the logistic regression, Cox proportional hazards regression, and decision tree models. The models developed in this study can be used to develop a clinical decision support system that automatically assesses risk for pressure ulcers to aid nurses.

• Archives of Plastic Surgery
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• 제46권5호
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• pp.455-461
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• 2019

Background Various surgical management methods have been proposed for ischial sore reconstruction, yet it has the highest recurrence rate of all pressure ulcer types. A novel approach combining the advantages of a perforator-based fasciocutaneous flap and a muscle flap is expected to resolve the disadvantages of previously introduced surgical methods. Methods Fifteen patients with ischial pressure ulcers with chronic osteomyelitis or bursitis, who underwent reconstructive procedures with an inferior gluteal artery perforator (IGAP) fasciocutaneous flap and a split inferior gluteus maximus muscle flap from January 2011 to June 2016, were analyzed retrospectively. The split muscle flap was rotated to obliterate the deep ischial defect, managing the osteomyelitis or bursitis, and the IGAP fasciocutaneous flap was rotated or advanced to cover the superficial layer. The patients' age, sex, presence of bursitis or osteomyelitis, surgical details, complications, follow-up period, and ischial sore recurrence were reviewed. Results All ischial pressure ulcers were successfully reconstructed without any flap loss. The mean duration of follow-up was 12.9 months (range, 3-35 months). Of 15 patients, one had a recurrent ulcer 10 months postoperatively, which was repaired by re-advancing the previously elevated fasciocutaneous flap. Conclusions The dual-flap procedure with an IGAP fasciocutaneous flap and split inferior gluteus maximus muscle flap for ischial pressure ulcer reconstruction is a useful method that combines the useful characteristics of perforator and muscle flaps, providing thick dual padding with sufficient vascularization while minimizing donor morbidity and vascular pedicle injury.

• 정보처리학회논문지:컴퓨터 및 통신 시스템
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• 제11권3호
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• pp.83-90
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• 2022

당뇨병은 오늘날 주변에서 흔히 찾아볼 수 있는 질병이며, 당뇨병성 족부 궤양(당뇨발)이라는 심각한 합병증으로 발전하는 사례 또한 많이 나타난다. 따라서 이를 사전에 진단하고 예방하는 것은 중요한 과제이며 본 논문에서 그 방안을 제시한다. 본문에서 소개하는 기존의 연구들을 바탕으로 발의 압력과 온도 정보는 당뇨발과 깊은 상관관계가 있음을 알 수 있으며, 해당 지표들을 측정하는 IoT 기기인 스마틴솔을 개발과정 및 아키텍쳐를 소개한다. 또한, 더 나아가 스마틴솔로 측정한 데이터들의 실제 당뇨발 진단을 위한 AI 분석 전처리 과정을 기술하며, 측정된 압력 그래프와 실제 사람의 발걸음 분포의 비교 등을 통해 실시간으로 수집하는 다중 정보들이 기존의 IoT 기기들보다 효율적이고 신뢰성 있다는 결과를 제시한다.

• 임상간호연구
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• 제15권1호
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• pp.133-147
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• 2009

Purpose: This study was conducted to construct evidence based clinical guidelines and to develop nursing process based performance measures for prevention and management of pressure ulcers, falls and pain. Method: Clinical guidelines were drafted through a comprehensive review of relevant literature, national guidelines and hospital protocols. The proposed guidelines were reviewed by a panel of experts and 90 hospital nurses, and refined on the basis of their suggestions. Nursing process based performance measures were developed based on the clinical guidelines and content validity was examined by surveys from 90 hospital nurses. Results: All items, except timetable for position change and pressure ulcer nursing record, in the guidelines for prevention and management of pressure ulcer were appropriate. Most items, except fall risk assessment tools, were appropriate for the guidelines of fall prevention. All other items, except the purpose of pain management, were appropriate for the guidelines of pain management. Performance measures developed in this study were acceptable as a tool to evaluate quality of nursing care. Conclusion: Nursing process based performance measures provide important indicators to monitor whether necessary nursing care is implemented and can be used as the primary resources to improve quality of nursing services.

• 대한족부족관절학회지
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• 제10권2호
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• pp.250-254
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• 2006

Purpose: The treatment of diabetic foot ulcers with total contact cast has been reported to be associated with numerous undesirable complications. This study shows that our technique of total contact casting that incorporates high concentration silver coated foam dressing. Materials and Methods: Forty-four diabetic foot ulcers were treated with total contact cast along with high concentration silver coated foam dressing. Complication and healing rates were evaluated. Results: Eighty five percent of the ulcers healed within 6 weeks with an overall complication rate of 7%. There were only two cases (5%) of infection and no recurrent ulceration and no another site new pressure ulcer in our study. Conclusion: Total contact casting incorporates high concentration silver coated foam dressing resulted in fewer complications rate and healing rate that is comparable to other studies.

• 한국인터넷방송통신학회논문지
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• 제18권5호
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• pp.215-222
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• 2018

최근 다양한 전동 침대의 개발과 보급이 활발하게 이루어지고 있다. 전동침대는 높이조절, 등판상승, 무릅상승, 틸트기능 및 좌우회전의 기능을 가지고 있으며 리모콘을 통해 편리하게 환자가 스스로 또는 보호자가 환자를 움직일 수 있다. 그러나 이미 나와 있는 의료용 전동침대에는 욕창방지, 시트교환, 환자의 이송기능이 없으므로 욕창 방지를 위해서는 욕창 방지 매트릭스를 사용하여 체압을 분산하고, 시트 교환이나 환자의 이송시에는 간병 인력이 붙어 일을 하게 된다. 하지만 이러한 일은 근력과 중노동을 수반함으로서 간호사들이 힘든 간호를 기피하는 현상이 발생하고 있다. 본 연구에서는 이러한 간호 업무를 수월하게 보조하기 위해 욕창방지, 시트교환 및 환자이송을 자동으로 행하는 다기능 병상을 개발하는 것을 목표로 하여 세계 최초의 시제품을 개발하고 시스템이 정상적으로 동작하는 것을 확인하였다. 앞으로 제안된 자동화된 다기능 전동 침상은 스마트 헬쓰케어를 위한 의료용 로봇의 한 모델이 될 수 있을 것으로 기대 된다.

• Archives of Reconstructive Microsurgery
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• 제15권2호
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• pp.107-110
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• 2006

Malignancy in a chronic pressure sore is rare among Marjolin's ulcers. Carcinomas arising in pressure sores are highly aggressive and usually fatal. Although carcinomas in pressure sores are generally well-differentiated squamous carcinomas, they can show quite an aggressive course and do not respond either to chemotherapy or radiotherapy. The mortality rate is high despite wide surgical resection. Extensive surgical excisions with wide surgical margins are necessary and elective lymph node dissection should be considered for optimal therapy. We report a squamous carcinoma arising in a pressure sore. The related literature was reviewed.

• 대한간호학회지
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• 제44권1호
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• pp.21-30
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• 2014

Purpose: This study was conducted to explore the impact of registered nurse/nurses' aid (RN/NA) staffing and turnover rate on inpatient health outcomes in long term care hospitals. Methods: A secondary analysis was done of national data from the Health Insurance Review and Assessment Services including evaluation of long term care hospitals in October-December 2010 and hospital general characteristics in July-September 2010. Final analysis of data from 610 hospitals included RN/NA staffing, turnover rate of nursing staff and 5 patient health outcome indicators. Results: Finding showed that, when variables of organization and community level were controlled, patients per RN was a significant indicator of decline in ADL for patients with dementia, and new pressure ulcer development in the high risk group and worsening of pressure ulcers. Patients per NA was a significant indicator for new pressure ulcer development in the low risk group. Turnover rate was not significant for any variable. Conclusion: To maintain and improve patient health outcomes of ADL and pressure ulcers, policies should be developed to increase the staffing level of RN. Studies are also needed to examine causal relation of NA staffing level, RN staffing level and patient health outcomes with consideration of the details of nursing practice.