• Journal of the Ergonomics Society of Korea
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• v.29 no.6
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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.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.23 no.3
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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.

• Journal of Korean Academy of Nursing
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• v.49 no.5
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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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• v.46 no.5
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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.

• KIPS Transactions on Computer and Communication Systems
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• v.11 no.3
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• pp.83-90
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• 2022

Diabetes is a common disease today, and there are also many cases of developing into serious complications called Diabetic Foot Ulcers(DFU). Diagnosis and prevention of DFU in advance is an important task, and this paper proposes the method. Based on existing studies introduced in the paper, it can be seen that foot pressure and temperature information are deeply correlated with DFU. Introduce the process and architecture of SmarTinsole, an IoT device that measures these indicators. Also, the paper describes the preprocessing process for AI-based diagnosis of DFU. Through the comparison of the measured pressure graph and the actual human step distribution, it presents the results that multiple information collected in real-time from SmarTinsole are more efficient and reliable than the previous study.

• Journal of Korean Clinical Nursing Research
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• v.15 no.1
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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.

• Journal of Korean Foot and Ankle Society
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• v.10 no.2
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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.

• The Journal of the Institute of Internet, Broadcasting and Communication
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• v.18 no.5
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• pp.215-222
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• 2018

Recently, various motion beds have been actively developed and popularized. The motion bed has the functions of height adjustment, back plate rising, knee lifting, tilt function and left / right rotation, and the remote control can conveniently be used by the patient himself or the caregiver to move the patient. However, since the medical bed for use does not have a function of preventing pressure ulcers, exchanging sheets, and transferring patients, it is necessary to disperse body pressure by using a pressure ulcer prevention matrix to prevent pressure ulcers. However, it is accompanied by muscle strength and hard work, and nurses are avoiding difficult nursing care. In this study, we developed the first prototype in the world and confirmed that the system works normally with the goal of developing multifunctional beds that automatically perform the prevention of bed sores, the exchange of sheets and the transfer of patients in order to facilitate such nursing work. It is anticipated that the proposed multifunctional motorized bed in the future will be a model of a medical robot for smart healthcare.

• Archives of Reconstructive Microsurgery
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• v.15 no.2
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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.

• Journal of Korean Academy of Nursing
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• v.44 no.1
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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.