A new concept: ‘Relative position between the external force and the bony prominence’ explains location-specific occurrence of superficial injury over an undermining lesion.

Aim A pressure ulcer is localized injury to the skin and/or underlying tissue usually over a bony prominence, as a result of pressure, or pressure in combination with shear. Although the external forces and bony prominences differ depending on ulcer location, the way in which these anatomical differ...

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Publicado en:Journal of Tissue Viability Vol. 26; no. 1; pp. 75 - 79
Autores principales: Takahashi, Yoshiko, Nemoto, Tetsuya, Mizokami, Fumihiro, Furuta, Katsunori, Murasawa, Yusuke, Yoneda, Masahiko, Isogai, Zenzo
Formato: research Journal Article
Publicado: Elsevier B.V. Feb2017
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Feb2017
      vid: 26
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      pub: Elsevier B.V.
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        10.1016/j.jtv.2016.08.001
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        atl: A new concept: ‘Relative position between the external force and the bony prominence’ explains location-specific occurrence of superficial injury over an undermining lesion.
      aug:
        au:
          Takahashi, Yoshiko
          Nemoto, Tetsuya
          Mizokami, Fumihiro
          Furuta, Katsunori
          Murasawa, Yusuke
          Yoneda, Masahiko
          Isogai, Zenzo
        affil: Department of Nursing & Health, School of Nursing & Health, Aichi Prefectural University, Nagoya, Aichi, Japan
      sug:
        subj:
          Pressure Ulcer Pathology
          Human
          Retrospective Design
          Sacrum
          Pressure Ulcer Classification
          Ischemia
          Pressure
      ab: Aim A pressure ulcer is localized injury to the skin and/or underlying tissue usually over a bony prominence, as a result of pressure, or pressure in combination with shear. Although the external forces and bony prominences differ depending on ulcer location, the way in which these anatomical differences affect pressure ulcer development is not well studied. Methods To clarify the location-dependent factors for pressure ulcer development, we focused on superficial injuries that develop over an undermining lesion, which we have termed them bilayer pressure ulcers. Because it is thought that a deep pressure ulcer is caused by ischemia at the deep lesion and a shallow pressure ulcer is caused by shear force to the superficial skin, a bilayer pressure ulcer can be considered a mixed phenotype, induced by both pressure and shear force. We retrospectively examined the frequency of bilayer pressure ulcers by location in a total of 568 pressure ulcers. Results The ratio of bilayer pressure ulcers to deep pressure ulcers staged III or more was significantly larger for pressure ulcers over the sacrum. Conclusion A new concept, the relative position between the external force and bony prominence, could explain the frequency and developmental mechanism of bilayer pressure ulcers. The external forces, shape of the bony prominence, and mobility of the soft tissue may be responsible for this concept.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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