• Journal of Korean Academy of Fundamentals of Nursing
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• v.5 no.2
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• pp.280-292
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• 1998

Pressure sores are a serious concerns in that respect to increasing risk of medical complications and medical costs. Prevention and care of pressure sores is an essential area of nursing practice. The nurse at ICU should be more careful of maintaining the skin integrity of patients especially than at any other place. This study was conducted to determine if the risk facotrs of pressure sores and nutritional status of the patients at risk for pressure sores is related the occurance of pressure sore. The risk group refers the patients having the below 14 scores of the braden scale. The 100 subjects were recruited from the ICU ward at an university hospital in Choongnam. The parameters for nutritional status are the blood chemistry including plasma protein, albumin, hemoglobin and the anthropometric measurements consisting of weight, BMI, LBM, the proportion of body fat, body fluid and triceps skin fold using bioimpedence analizer and caliper. The results are as follows : 1. The subjects were 55 years and stayed 8 days on average. Of the 100 subjects, males were 61%, neurologic/neurosurgical diseases were 68% and the incidence of pressure sores was 17% mainly occuring within 3days after the admission. 2. The present paralysis(or paraplegia) and edema(arm, leg, trunk) were showed more significantly the subjects with pressure sores than those without pressure sores. 3. Regarding with the nutritional status, the subjects with pressure sores had significantly lower the weight, BMI, LBM, body fluid, albumin than the ones without pressure sores. This results were supported the reports of previous studies that the decreased weight and albumin could be the important predictors of pressure sores. Thereafter we should encourage these factors to be utilized in predicting pressure sores for a comprehensive assessment. Nurse should identify patients at risk of the development of pressure sores, assess their nutritional status and dietary intake at regular intervals.

• Korean Journal of Adult Nursing
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• v.16 no.2
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• pp.183-190
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• 2004

Purpose: The purpose of this study was To exam the skin and pressure sore and To evaluate the predictive validity for the new pressure sores risk assessment scale. Method: There was finally 211 neurosurgery subject admitted in Chung-Ang Univ. Hospital from Nov, 11, 2002 to Feb, 11, 2003. Data was collected three times per week from 48-72hr after admission until incidence of pressure sores or discharge or die. Inclusion criteria were; (1) no pressure sores at admittance, (2) at least 3 times assessment, (3) adults older than 16yrs, (4) patients consent to participate in study. Result: 1. 34 case of 211 developed pressure sores(11.6%). 2. The coccyx area was the most common occurrence site of pressure sores. 3. At the cutoff point 23 of sensitivity 100%, specificity 76.3% was higher in 2003 than specificity 63.8% at the cutoff point 26 of sencitivity 100% in 1991. 4. "Moisture" of subscale for pressure sores risk factor was the strongest predictor. Conclusion: This study shows that the New Pressure Sores Risk Assessment Scale still predict the risk of developing pressure sores in neurosurgical subject.

• The Journal of Korean Physical Therapy
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• v.12 no.2
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• pp.229-238
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• 2000

A properly prescribed wheelchair may be able to normalize tone. decrease pathologic reflex activity, improve postural symmetry, enhance range of movement, maintain and/or improve skin conduit)n. increase comfort and sitting tolerance, decrease fatigue, and improve function of the autonomic nervous system. Whereas a poorly prescribed one can actually exacerbate the problems associated with a disability. Maintained for longer without relief, pressure concentrations may also lead to tissue breakdown. Pressure sores continue to be a major problem for many disabled individuals. Many groups of disabled individuals have a very high incidence of pressure sores, including those individuals with spinal cord injuries. hemiplegia, multiple sclerosis. cancer. and the disabled geriatric population. It is important to understand the factors which predispose an individuals to the development of a pressure sores. Those factors can divided into extrinsic factors, related to the individual's immediate environment and intrinsic factors. related to their medical or physical condition. Pressure sores are generally preventable through sensible pressure management based on an understanding of the causes of pressure sores, risk factors and methods of redistributing pressure.

• IEMEK Journal of Embedded Systems and Applications
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• v.6 no.4
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• pp.209-214
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• 2011

This study suggests a Healthcare System for elderly and disabled who have mobility impairment and use a wheelchair for long time. Seating long time in a wheelchair without reducing pressure causes high risk of developing pressure sores. Pressure sores come with great deal of pain and often lead to develop complication. Not only it takes time and effort to treat pressure sores but also increases medical expenses. Therefore, we will develop a device to help to prevent pressure sores by measuring pressure distribution while seating in a wheelchair and wirelessly send information to user device to check pressure distribution in real time. The equipment to measure body pressure is composed of FSR sitting mat which is a sensor measuring part and an user terminal which is a monitoring part. The designed mat is matrix formed FSR sensor to measure pressure. The sensor send measured data to the controller which is connected to the end of the mat, and then the collected data are sent to an user terminal through a bluetooth. Developing a pressure monitoring system will help to prevent those who have mobility impairment to manage pressure sores and furthermore relieve their burden of medical expenses.

• Proceedings of the KIEE Conference
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• 2009.07a
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• pp.1974_1975
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• 2009

The chairbound, handicapped person often requires a cushion to distribute the supportive forces over the largest area possible in order to reduce the risk of the development of a pressure sore. Pressure sores are areas of damaged skin caused by staying in one position for too long and can cause serious infections, some of which are life-threatening. When sitting upright, the greatest proportion of body weight is centerd over the ischial tuberosities. So, it is important that comfortable seating and largest distribution of pressure to prevent pressure sores. Therefore, the objective of this study was to develop the physical pressure measurement device and orthodontic chair to prevent pressure sores.

• Archives of Plastic Surgery
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• v.37 no.5
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• pp.595-599
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• 2010

Purpose: Trochanteric pressure sores management has been improved through the development of musculocutaneous flaps. But it has many drawbacks such as donor site morbidity and functional muscle sacrifice. With the introduction of perforator flap, it is possible to use in every location where musculocutaneous perforators are present. We have reconstructed trochanteric pressure sores using perforator-based flaps from the ascending branch of lateral circumflex femoral artery. Methods: Between May of 2006 and April of 2008, we performed six cases of perforator-based flap from the ascending branch of lateral circumflex femoral artery for the coverage of trochanteric pressure sores. For identifying perforators, a line was drawn from the anterior superior iliac spine to the superolateral border of the patella as the vertical axis, from the pubis to the trochanteric prominence as the horizontal axis. In the lateral aspect of the intersection of these two axes, various flap were designed according to its defects. The flap was raised in the subcutaneous plane above the fascia and the pedicle was traced by doppler and identified. The pedicle was meticulously dissected not to injure the periadventitial tissues and transposed to the defect. The donor site was closed primarily. Results: The mean age of patients was 56.2 years. Four male and two female patients were studied. Five patients were paraplegic. The mean defect size was $6{\times}4\;cm$. The largest flap dimension was $14{\times}7\;cm$. Donor sites were closed primarily without any complications. All flaps survived completely without necrosis, hematoma or infection. There were no recurrence during the follow-up period. Conclusion: Trochanteric pressure sores using perforator-based flap from the ascending branch of lateral circumflex femoral artery can be performed safely and it would be a reliable option for coverage of trochanteric pressure sores with minimal donor site morbidity.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.6 no.2
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• pp.267-276
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• 1999

The purpose of this study was to identify risk factors predictive of alterations in skin integrity during the intraoperative period. The predictive risk factors were studied for intraoperative pressure sores from December 1998 through January 1999. A sample of 220 patients was selected from the operating room schedule of a University Hospital in Pusan. There were two criteria in including patients : the operation lasted longer than 2 hours and the absence of skin break-down according to NPUAP criteria. The data were analized by SPSS/PC, Stepwise multiple logistic regression was used to identify the variables which were predictive of alterations in skin integrity. Of the 220 patients studied, 41 patients (18.6%) developed stage 1 pressure sores in the immediate postoperative period. In relation to skin changes, three independent variables emerged from the stepwise multiple logistic regression as being significant (p<0.05). Factors predictive of pressure sore formation included low serum albumin(p=0.000), prone position while undergoing surgery(p=0.0004), time on the operating table(p=0.0165). Among the intrinsic factors, serum albumin was the most significant causal factor in pressure sores development in the intra-operative period. Pressure and shearing force were the most significant extrinsic factors in pressure sores development. From the results of this study we concluded that the primary nursing goal is the maintenance of the proper patient' position during the intraoperative period. Also imperative for sore prevention is the reduction of surgery time and improving preoperative nutritional status.

• Archives of Plastic Surgery
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• v.32 no.6
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• pp.782-786
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• 2005

Pressure sores are a common complication of hospitalized patients. However, It is often impossible to correct surgically because the general conditions of these patients are poor. It is known that the hydrogel has a powerful autolytic effect by providing moist environments and facilitates wound healing and hydrocolloid dressing is also known to promotes granulation tissue formation and epithelialization. The patients were treated with hydrogel(Purion $gel^{(R)}$, Coloplast A/S, Denmark) and hydrocolloid dressing (Comfeel Plus Transparent $Dressing^{(R)}$, Coloplast A/S, Denmark) after surgical debridement of pressure sores progressed to stage III(n=2) and IV(n=7). This combination treatment could facilitate to debride the nectrotic tissue and promote granulation tissue formation epithelialization simultaneously. We could achieve complete healing of pressure sores using the combination treatment without requiring surgical correction. In conclusion, hydrogel in combination with hydrocolloid dressing is effective in acheiving complete healing of progressed pressure sores.

• Archives of Plastic Surgery
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• v.38 no.6
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• pp.815-820
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• 2011

Purpose: Perforator flaps have been widely used for reconstruction of pressure sores because they have many benefits, especially reducing tension. Otherwise in order to prevent recurrence of a pressure sore, sufficient thickness of a flap is desirable, so a musculocutaneous flap is also useful for reconstruction of a pressure sore. Therefore, the authors considered about the postoperative results of reconstruction of pressure sores between using perforator flaps and musculocutaneous flaps. Methods: In this study, 33 patients (46 flaps) who underwent reconstructive operation of pressure sores from January 2007 to February 2011 were reviewed. Patients operated by using perforator flaps were 18 (18 flaps), and musculocutaneous flaps were 17 (28 flaps). We studied postoperative complications and recurrence. Results: We experienced five patients (10 flaps) with complications or recurrences who were operated using musculocutaneous flaps and one patient using a perforator flap. One case using a perforator flap stemmed from dehiscence caused by a urinary fistula occurring in two months after the surgery. Among ten cases using musculocutaneous flaps, one case was caused by total necrosis of flap, five cases by partial necrosis of flap and dehiscence, and four cases by recurrences during follow-up period. Conclusion: Even if more cases were required, it can be more considerable to operate using the perforator flap rather than the musculocutaneous flap to reduce the complication or recurrence of pressure sore.

• Archives of Reconstructive Microsurgery
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• v.11 no.1
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• pp.47-52
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• 2002

One of the most common problems in cord injury is pressure sores. In the early stage of pressure sores, the wound can be covered by advancing or transpositioning a local myocutaneous flap. However, it can be a great challenge to treat end-stage paraplegic patient who underwent multiple prior flaps, where continuous treatment is needed to prevent recurrent pressure sore due to infection and metabolic drain. In these patients, a local myocutaneous flap may be very difficult for coverage of the wounds. Therefore, hemipelvectomy may be considered. The authors performed a hemipelvectomy on a 33 year-old male paraplegic patient who presented with multiple, large wounds seen in end-stage pressure sores. He had a compression fracture of the lumber spine 9 years ago during a motor vehicle accident. After a wide exicision of the wound, the anterior flap was used as a fillet-flap for reconstruction. On the sixth day postoperatively, secondary repair was done due to wound dehiscence and the postoperative results have been satisfactory thus far.