(Pressure Ulcer Management) - Chiang Mai University

1 3 ( pressure Ulcer Management) 1. 2. 3. 4.. 55 ( pressure Ulcer Managements) (Structures and functions of skin) (Skin) 3 1 1. (epidermis) (keratinocyte) 5-10 10-20 2.

2 (dermis) 10-20 (fibroblast) 3. (subcutaneous tissue) (fascia) (fibrous tissue) (adepocytes) 1 : 56 (Types of wound healing) 3 1.

3 (Primary healing) 3-14 2. (Secondary healing) granulation tissue epithelialization 3. (Tertiary healing) granulation tissue (delayed primary closure) (skin graft) (Phase of Wound Healing) 3 1.

4 (inflammatory phase) 1-4 (blood clot) (hemostasis) platelet-derived growth factor (PDGF) neutrophil monocyte neutrophil macrophage cytokines collagenase interleukins tumor necrotic factor fibroblast 2.

5 (proliferative phase) 5-20 (collagen) (extracellular matrix) granulation epithelium 57 exudate eschar reepithelization 3. (remodeling phase) 21 2 80-85 3 2 2 : Ho CH and Bogie K.

6 pressure ulcers. In: Frontera WR, DeLisa JA, Gans BM, Walsh NE, Robinson LR, Basford J, et al. editors. Physical medicine and rehabilitation: principles and practice vol. 2, 5th ed. USA: Lippincott Williams p. 1393-1405. 58 ( pressure Ulcer ) .. 2009 International NPUAP-EPUAP pressure Ulcer Prevention and Treatment Clinical Practice Guideline ( pressure ) (shear) (friction) (Incidence and prevalence) 2552 11,000 80.

7 2550-2552 6 70 / 61 2 70,916 ( pressure Ulcer pathophysiology) 3 1. ( pressure ) 59 (ischemia) 2.

8 (Shear) 6 3. (Friction) 2 1. Static friction (Sliding) 2. Dynamic friction (sliding) (abrasion) (blister) (friction) 3 : ) 60 1.

9 (Aging) 2. (Immobility) / 3. (Impaired sensation) 4. (Malnutrition) - (hypoalbuminemia) (hypoproteinemia) - - - (dehydration) - (hypocholesterolemia) - (cachexia) Lean body mass total body mass 5.

10 (Anemia) 6. (Smoking) carbon monoxide nicotinic acid 7. (High body temperature) 8. (Moisture and Incontinence) 9. (Medication) 61 (Assessment of pressure Ulcer ) (Staging of pressure Ulcer ) National pressure Ulcer Advisory Panel (NPUAP)