title: Wound fixation for pressure ulcers: a new therapeutic concept based on the physical properties of wounds.
abstract: A pressure ulcer is defined as damage to skin and other tissues over a bony prominence caused by excess pressure. Deep pressure ulcers that develop over specific bony prominences often exhibit wound deformity, defined as a change in the 3-dimensional shape of the wound. Subsequently, the wound deformity can result in undermining formation, which is a characteristic of deep pressure ulcers. However, to date, a concept with respect to alleviating wound deformity has yet to be defined and described. To clarify the issue, we propose a new concept called "wound fixation" based on the physical properties of deep pressure ulcers with wound deformity. Wound fixation is defined here as the alleviation of wound deformity by exogenous materials. The wound fixation methods are classified as traction, anchor, and insertion based on the relation between the wound and action point by the exogenous materials. A retrospective survey of a case series showed that wound fixation was preferentially used for deep pressure ulcers at specific locations such as the sacrum, coccyx, and greater trochanter. Moreover, the methods of wound fixation were dependent on the pressure ulcer location. In conclusion, our new concept of wound fixation will be useful for the practical treatment and care of pressure ulcers. Further discussion and validation by other experts will be required to establish this concept.
authors: Department of Pharmacy, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan.
authors: Fumihiro
authors: F
authors: Mizokami
authors: Department of Nursing & Health, School of Nursing & Health, Aichi Prefectural University, Nagoya, Aichi, Japan.
authors: Yoshiko
authors: Y
authors: Takahashi
authors: Department of Gerontechnology, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan.
authors: Tetsuya
authors: T
authors: Nemoto
authors: Department of Dermatology, Gunma University School of Medicine, Maebashi, Gunma, Japan.
authors: Yayoi
authors: Y
authors: Nagai
authors: Graduate Division of Health and Welfare, Department of Nursing and Human Nutrition, Yamaguchi Prefectural University, Yamaguchi, Japan.
authors: Makiko
authors: M
authors: Tanaka
authors: Department of Dermatology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.
authors: Atsushi
authors: A
authors: Utani
authors: Department of Pharmacy, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan; Department of Clinical Research and Development, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan.
authors: Katsunori
authors: K
authors: Furuta
authors: Division of Dermatology and Connective Tissue Medicine, Department of Advanced Medicine, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan. Electronic address: zenzo@ncgg.go.jp.
authors: Zenzo
authors: Z
authors: Isogai
mesh_terms: D006801:Humans; D003668:Pressure Ulcer / Q000628:therapy*; D016707:Tissue Fixation
keywords: Pressure ulcer; Undermining formation; Wound deformity; Wound fixation