摘要：Objective The present study aims to explore the individualized treatment options for multisite pressure ulcer (PU) at various stages in elderly patients with multiple medical conditions. Methods Stages 1 and 2 PU at 146 sites were treated with closed negative pressure suction combined with continuous micro-oxygen perfusion and the local application of foam dressings, silver ion dressings, and moist burn cream. Stages 3 and 4 PU in the sacrococcygeal region were treated with skin or myocutaneous flap transplantation. Results Stages 1 and 2 PU healed after treatment with closed negative pressure suction combined with continuous micro-oxygen perfusion and dressing changes. One case died during hospitalization due to an illness. Skin or myocutaneous flap repair was conducted in 34 cases of stage 3 or 4 PU in the sacrococcygeal area. Of these cases, 28 achieved primary healing, and 6 required two or three surgeries, 5 of which received micro-skin implantation. In addition, 10 small deep PU at other sites were repaired by direct excision and suturing or local flap repair. Seven cases were transferred to other departments or hospitals due to concomitant diseases or were discharged automatically without surgical treatment. Conclusion Home care for geriatric patients is difficult. PU often occur at multiple sites because of the duration of various pressures, and different sites may demonstrate different stages because of varying degrees of pressure. When actively treating stages 3 and 4 PU, the trauma management of stages 1 and 2 PU should not be neglected.

摘要：Objective:The objective is to outline the overall health scene as it is in New Zealand and to demonstrate that there is tremendous potential for the increased use of Moist Exposed Burn Therapy(MEBT)across a wide variety of health care facilities within New Zealand.Method:The presentation allows me to share with you evidence from clini- cal based practice and examples of how and where MEBT and the product Moist Exposed Burn Ointment(MEBO)has been used within New Zealand' s health services.This will include evidence from other nursing colleagues who work in the Aged Care sector or in the New Zealand community.Result:My experiences in the clinical field have enabled me to see that there is much that can be done through education for nurses by professional nurse educators. Currently there is little or no funding available to Nurse Educators for them to be able to provide the required education and training,or to be able to introduce the correct clini- cal techniques of MEBT into our heahhcare profession. Patients who require wound management and have been treated using the MEBT method are provided with sustained wound healing,improved outcomes and consequently an improved quality of life. New Zealand health providers are beginning to realize that use of MEBT and MEBO is a cost effective form of treatment.Not only in monetary terms but in ethical and physiolog- ical terms as well.At this point in time however,there is evidence that nurses will experi- ment with products such as MEBO but revert back to techniques and products they know and are comfortable with in day to day nursing situations. It can therefore be concluded that New Zealand nurses do not have adequate knowl- edge or understanding of the clinical application of MEBT/MEBO to achieve the optimum results for their patients. Ongoing education is essential to ensure that nurses,who are using MEBT,under- stand the principals of MEBT and follow the correct clinical application. There has been evidence,during my clinical practice,of New Zealand nurses using MEBT alongside the current New Zealand wound management techniques and this combi- nation has often led to a misunderstanding about MEBT and the incorrect use of MEBO. As a result the patient outcomes are often substandard compared with the recommen- ded MEBT practice and the resulting potential for the increased quality of life is not fully realized by patient or practitioner. With the acceptance of a changing methodology and its education within the New Zea- land nursing culture,there is significant potential for this wound management concept to be widely used,particularly within the Aged Care and Disabilities sectors within New Zea- land prior to registration of MEBO being granted. With the full registration of the MEBO product,we will be able to use this treatment to its full potential to provide improved patient outcomes and an increase in quality of life for patients within New Zealand. My clinical knowledge of MEBT has helped me to initiate a starting point of MEBT education in New Zealand-currently focused on regional nurse education and community awareness.This will help facilitate the understanding,enthusiasm and commitment for this treatment across New Zealand and enable nurses to gain the necessary support to bring a- bout this change in wound management.