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욕창의 발병기전과 예방

Pathogenesis and prevention of pressure ulcer

대한의사협회지 2021년 64권 1호 p.16 ~ 25
도경현, 허찬영,
소속 상세정보
도경현 ( Doh Gyeong-Hyeon ) - Seoul National University Bundang Hospital Department of Plastic and Reconstructive Surgery
허찬영 ( Heo Chan-Yeong ) - Seoul National University Bundang Hospital Department of Plastic and Reconstructive Surgery

Abstract


The number of pressure ulcer patients is increasing owing to the aging population and increased incidence of elderly illness. This review article aims to introduce the current knowledge on the pathogenesis and prevention of pressure ulcers. The development of a pressure ulcer is associated with external factors such as pressure, shear stress, and friction and internal factors such as age, general condition, skin condition, and nutritional status. Pressure ulcers typically develop over bone protrusions, which are most pressured by weight, but may also be caused by external pressure by medical devices or other objects applied to the patient. This tissue damage is caused by continuous deformation of the tissue due to the pressure acting perpendicular to the tissue surface and shear stress acting parallel to the tissue, either alone or in combination. Limitation of activity and mobility, skin condition, blood circulation and oxygen saturation, nutrition, humidity, body temperature, age, low pain sensitivity, blood count, and general and mental conditions are the primary risk factors for pressure ulcers. A mattress and cushion that reduce pressure and an appropriate posture are necessary to prevent pressure ulcers. In patients with urinary incontinence, contaminated skin should be washed with a mild detergent and absorbent pads and topical protective agents should be used to protect the skin from moisture. Sufficient nutrition may help prevent wounds in patients who are susceptible to pressure ulcers. Furthermore, early screening, individualized management of posture, and regular skin and nutrition monitoring are essential to prevent pressure ulcers.

키워드

욕창; 발병기전; 예방; 위험인자
Pressure ulcer; Pathogenesis; Prevention; Risk factors

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