NAGAKAWA Takukazu Faculty of Medicine, Kanazawa University, Professor, 医学部, 教授 (50019600)
KONYA Chizuko Faculty of Medicine, Kanazawa University, Associate Professor, 医学部, 助手 (20303282)
SUGAMA Junko Faculty of Medicine, Kanazawa University, Associate Professor, 医学部, 助教授 (00203307)
|Budget Amount *help
¥3,400,000 (Direct Cost : ¥3,400,000)
Fiscal Year 2000 : ¥700,000 (Direct Cost : ¥700,000)
Fiscal Year 1999 : ¥500,000 (Direct Cost : ¥500,000)
Fiscal Year 1998 : ¥2,200,000 (Direct Cost : ¥2,200,000)
Purpose: We analyzed the morphology of pressure ulcer and the factor influencing the development of pressure ulcer in elderly patients, to clarify the relationship between morphological stage of incurable pressure ulcer and the care management.
Objects: Objects were 115 patients (male 37, female 78) who admitted, mainly by cardiovascular diseases in hospital. Mean age and SD was 81.4± 7.0 tear and the informed consent for photographic examination was taken from all patients.
Methods: 1. The pressure ulcered cured in standard, course were classified by the region, the stages of ulcer, and morphology. 2. The pressure ulcers which were incurable for more than one year were classified as same manner. 3. The relationship between the curable course of the pressure ulcer and the care management was analyzed. Staging of depth of pressure ulcers was classified by NPIJAP classification. Result: 1 Main region seen in the pressure ulcers that were normally cured in standard course was sacral region
(44 patients). Duration for cure was increased with stage of depth. Formation of the pocket was detected in stage II and IV and the pocket surrounding all margins was only found in stage IV. Stage I was categorized into two subgroup by the degree of redness, stage II into two by the presence of necrotic tissue, stage II into three by the presence of pocket formation, and stage IV into five by the condition of attachment of the necrotic tissue and morphology of pocket.
The 13 pressure ulcers incurable within one year were found at sacrum, coccyx, major trochanter, and ischial tuberosities. The etiology of prolonged for cure was estimated to be an in sufficient proliferation of granuloma, thickness, maceration, hyperketoratosis and tension at ulcer margin. The ulcer was morphologically categorized into six subgroups by the epithelization, the cure stage of pocket, and the proliferation of granuloma.
3. From the analysis of the relationship between curable course of the pressure ulcer and care management, the introduction of care management with improvement of pressure, slipping, cleanness, and the change of position accelerated the cure of pressure ulcer. The curative period of pressure ulcer at sacrum with contraction was tendency to be long.
From these results, a new classification in stage of curative pressure ulcer was found by the categorization of pressure ulcer in the curative stage. Using this method, it will be possible to achieve the estimation of cure and the effective care management.