足踝减压垫在骨科下肢牵引术防止足跟压疮中的应用
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摘要
目的设计一种足踝减压垫,并讨论其在骨科下肢牵引术防止足跟压疮中的应用效果。方法收集2017年12月-2018年6月在我院骨科住院采取牵引术的患者40例,其中男25例,女15例;年龄52～87岁,平均73岁;其中27例行皮牵引术,13例行骨牵引术。所有行下肢牵引术的患者均采用足踝减压垫预足跟压疮。足踝减压垫的整体结构类长方体(长度为14 cm、宽度为11 cm、高度为9 cm),其上部分沿长轴方向有一个深度为6 cm U型凹槽。在凹槽的底部和内外侧有三个凹陷,分别用于容纳足跟部、足内踝和外踝。减压垫的构成主体材料为泡沫海绵或者记忆棉,其外表面附有一层棉麻布,以提高耐磨度和摩擦力;其内表面及三个凹陷处均贴附有一层绒布以使患者足跟部或足踝部更加舒适。结果 40例使用足踝减压垫的牵引患者中39例未出现足跟压疮及其它不良反应,整体有效率达97.5%。足踝减压垫不仅不影响牵引效果,同时可防止足部内外旋,并且可预防牵引术患者足跟压疮。结论足踝减压垫结构简单、制作简便、成本低廉,它可有效地预防骨科下肢牵引术患者足跟压疮,缩短患者住院时间及降低患者医疗费用。它具有良好临床效果和社会效益,值得临床上推广。
Objective To observe the effect of a self-designed ankle decompression pad on the prevention of heel pressure ulcers in orthopaedic patients with lower limb traction. Methods A total of 40 patients admitted to our hospital for lower limb traction from December 2017 to June 2018 were collected, including 25 males and 15 females with 52～87 years old(average 73 years old). Among them, 27 cases underwent skin traction and 13 cases received bone traction. All patients who underwent lower limb traction were treated with ankle decompression pad to prevent heel pressure score. The overall structure of the ankle decompression pad is cuboid-like sharp(length 14 cm, width11 cm, height 9 cm) and the upper part has a u-shaped groove with 6 cm depth along the long axis. There are three indentations at the bottom, medial and lateral of the groove, which are used to accommodate the heel part, the medial and the lateral malleolus respectively. The main material of the ankle decompression pad is foam sponge or memory cotton. Its outer surface is attached with a layer of cotton and hemp cloth for improving wear resisting degree and friction force. Its inner surface and three indentations are covered with a layer of flannelette to make the heel part, the medial and the lateral malleolus of patients more comfortable. To evaluate the effect of ankle decompression pad for preventing heel pressure ulcer in orthopaedic patients with lower limb traction. Results There was no heel pressure score or other adverse reactions in 39 cases of the 40 patients with the lower limb traction and treatment of the foot ankle decompression pad, and the overall effective rate was up to 97.5%. The foot ankle decompression pad not only doesn't af fect traction ef fect, but also can prevent the foot from internal and external rotation, and can prevent heel pressure ulcer in patients with traction. Conclusion The foot ankle decompression pad is simple in structure, easy to made and low in cost. It can effectively prevent heel pressure score in orthopaedic patients with lower limb traction,shorten the length of hospital stay, and reduce patients' medical costs.
Objective To observe the effect of a self-designed ankle decompression pad on the prevention of heel pressure ulcers in orthopaedic patients with lower limb traction. Methods A total of 40 patients admitted to our hospital for lower limb traction from December 2017 to June 2018 were collected, including 25 males and 15 females with 52～87 years old(average 73 years old). Among them, 27 cases underwent skin traction and 13 cases received bone traction. All patients who underwent lower limb traction were treated with ankle decompression pad to prevent heel pressure score. The overall structure of the ankle decompression pad is cuboid-like sharp(length 14 cm, width11 cm, height 9 cm) and the upper part has a u-shaped groove with 6 cm depth along the long axis. There are three indentations at the bottom, medial and lateral of the groove, which are used to accommodate the heel part, the medial and the lateral malleolus respectively. The main material of the ankle decompression pad is foam sponge or memory cotton. Its outer surface is attached with a layer of cotton and hemp cloth for improving wear resisting degree and friction force. Its inner surface and three indentations are covered with a layer of flannelette to make the heel part, the medial and the lateral malleolus of patients more comfortable. To evaluate the effect of ankle decompression pad for preventing heel pressure ulcer in orthopaedic patients with lower limb traction. Results There was no heel pressure score or other adverse reactions in 39 cases of the 40 patients with the lower limb traction and treatment of the foot ankle decompression pad, and the overall effective rate was up to 97.5%. The foot ankle decompression pad not only doesn't af fect traction ef fect, but also can prevent the foot from internal and external rotation, and can prevent heel pressure ulcer in patients with traction. Conclusion The foot ankle decompression pad is simple in structure, easy to made and low in cost. It can effectively prevent heel pressure score in orthopaedic patients with lower limb traction,shorten the length of hospital stay, and reduce patients' medical costs.
引文
[1]张红文.探讨骨科牵引术对下肢创伤患者的临床疗效分析[J].世界最新医学信息文摘(电子版),2014,14(12):104-105.
[2]周源,徐海林.关节牵引术治疗创伤后踝关节炎[J].中国骨与关节外科,2013,6(4):383-386.
[3]尚少梅.护理学基础[M].北京:北京大学医学出版社,2015:3.
[4]LYMAN V.2009.Successful heel pressure ulcer prevention in a long-term care setting[J].Journal of Wound,Ostomy&Continence Nursing,36(6):616-621.
[5]THOMAS D R,COMPTON G A.Pressure ulcers in the aging population:a guide for clinicians[J].Springer,New York,2014:101-110.
[6]LYMAN V.Successful heel pressure ulcer prevention in a long-term care setting[J].Journal of Wound,Ostomy&Continence Nursing,2009,36(6):616-621.
[7]THOMAS D R,COMPTON G A.Pressure ulcers in the aging population[J].Aging Medinine,2014,1.
[8]DELMORE B,LEBOVITS S,SUGGS B,et al.2015.Risks factors associated with heel pressure ulcers in hospitalized patients[J].Journal of Wound,Ostomy&Continence Nursing,2015,42(3):242-248.
[2]周源,徐海林.关节牵引术治疗创伤后踝关节炎[J].中国骨与关节外科,2013,6(4):383-386.
[3]尚少梅.护理学基础[M].北京:北京大学医学出版社,2015:3.
[4]LYMAN V.2009.Successful heel pressure ulcer prevention in a long-term care setting[J].Journal of Wound,Ostomy&Continence Nursing,36(6):616-621.
[5]THOMAS D R,COMPTON G A.Pressure ulcers in the aging population:a guide for clinicians[J].Springer,New York,2014:101-110.
[6]LYMAN V.Successful heel pressure ulcer prevention in a long-term care setting[J].Journal of Wound,Ostomy&Continence Nursing,2009,36(6):616-621.
[7]THOMAS D R,COMPTON G A.Pressure ulcers in the aging population[J].Aging Medinine,2014,1.
[8]DELMORE B,LEBOVITS S,SUGGS B,et al.2015.Risks factors associated with heel pressure ulcers in hospitalized patients[J].Journal of Wound,Ostomy&Continence Nursing,2015,42(3):242-248.