일에서 2008년 60.8일로 증가하였다(Nam & Lim, 2012). 또한 2005년 전국 가정전문간호사업소를 대상으로 가정 간호 서비스를 분석한 결과 욕창치료로 가정전문간호사가 방문한 사례가 1인당 월 29.5회로 가장 많은 것으로 나타나 욕창관리의 중요성이 부각되었다(Ryu, Park, Kim, Kwon, & Kang, 2008). 욕창관리를 받는 가정 간호 대상자 중 40.2%가 3-4단계의 욕창이었으며, 간호중재 방법으로 습포드레싱, 항생제 연고 도포 및 느릅나무 근피 드레싱과 같은 민간요법을 사용하고 있는 것으로 확인되었다(Kim, Cho, & Park, 1997; Kim & Park, 2009). 욕창의 조직재생과정은 일반적으로 염증기(inflammatory phase), 증식기(proliferative phase), 성숙기(maturational phase)의 3단계를 거치며, 특히 3기 이상의 욕창은 개방된 창상에서 현저한 조직의 결손이나 괴사 또는 감염을 유발할 수 있고 이차유합에 의한 치유과정이 일어난다. 치유과정을 촉진하는 인자로는 섬유아세포성장인자(fibroblast growth factor, FGF), 혈관내피성장인자(vascular endothelial growth factor, VEGF), 혈소판유래성장인자(platelet-derived growth factor, PDGF), 형질변환성장인자(transforming growth factor , TGF- ) 등이 있으며(Gabriel, Mussman, Rosenberg, & Torre, 2003; R&D system, 2002), Dai 등(2012)은 FGF와 VEGF의 발현은 3-4기 욕창의 창상회복과 유의한 관련성이 있다고 하였다.
Purpose: The purpose of this study was to investigate the effect of Ulmus root-bark dressing in fibroblast growth factor (FGF) and vascular endothelial growth factor (VEGF) of induced pressure ulcers in rats. Methods: 54 male Sprague-Dawley rats were used and randomly divided into 2 groups. The rats were anesthetized and pressure ulcers were induced at 140 mmHg for three hours, using a personally-designed pressing apparatus. Ulmus dressing was applied in the experimental group (n=27) and saline gauze dressing in the control group (n=27). Each of the dressings was changed every other day, and after a month, the wounds were examined by microscopy biweekly for 20 weeks. Results: After 4 weeks, the epidermis of the wounds was recovered, but inflammatory infiltration of the dermis was remained. After 6 weeks, inflammatory cells were diminished and the number of capillaries was decreased. Examined by immunofluorescence staining, the FGF positive cells in the experimental group changed negatively after 18 weeks, but the control group still existed even after 20 weeks. VEGF positive cells in the experimental group also changed negatively after 20 weeks, but the control group still existed. Conclusion: The findings of this study demonstrate that Ulmus dressing is effective in minimizing scar formation and inflammatory reaction by decreasing FGF and VEGF in the terminal phase of wound healing.
서 론 연구 방법 연구 결과 논 의 결론 및 제언 REFERENCES
