| 1. |
- Lindgren, Margareta, 1951-, et al.
(författare)
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Altered skin blood perfusion in areas with non blanchable erythema : an explorative study
- 2006
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Ingår i: International Wound Journal. - 1742-4801 .- 1742-481X. ; 3:3, s. 215-223
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Tidskriftsartikel (refereegranskat)abstract
- Non blanchable erythema, i.e. stage I pressure ulcer, is common in patients in acute and geriatric care and in nursing homes. Research has shown that this type of lesions is prone to develop into more severe pressure ulcers. The peripheral skin blood perfusion is of major importance for the development of pressure ulcers. The aim of this study was to explore the peripheral skin blood perfusion over time, in areas with non blanchable erythema and in corresponding undamaged areas on the opposite side of the body. A total of 19 measurements were performed, over time, using a laser Doppler perfusion imager. The blood flow distribution profiles over areas with non blanchable erythema and undamaged skin were found to be different. As the area of the non blanchable erythema decreased, the blood perfusion distribution profiles gradually became more heterogeneous; an area of high blood perfusion in the centre of the lesions was seen and the perfusion successively decreased closer to the edge. These results indicate that there are differences in blood perfusion between skin areas of non blanchable erythema and undamaged skin. The results also indicate that the visible redness in areas with non blanchable erythema is related to altered blood perfusion. The skin blood perfusion also seems to increase in relation to the size of the non blanchable erythema.
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| 2. |
- Malmqvist, Lars-Åke, 1951-
(författare)
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Sympathetic neural blockade during regional analgesia : Clinical investigations in man
- 1992
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Different opinions exist concerning the extent and intensi-ty of the concomitant sympathetic block during regional blockade, and how to test the completeness of the sympathetic blockade. Studies were performed on 21 volunteers and 162 patients scheduled for surgery of the urogenital area or surgery for varicose v-eins, and chronic pain patients. The regional blockades used were intrathecal, extradural or stellate ganglion blockade. The skin resistance response method (SRR) was used for recording sympathetic nervous activity in all studies. Laser Doppler flowmetry and skin temperature recordings were used during stellate ganglion blockade, to evaluate changes in skin blood flow and skin temperature. Changes in cardiac output were evaluated by the dye dilution method or thoracic impedance cardiography. Vagal activity was evaluated by recording changes in RR intervals from the electrocardiogram (ECG). Afferent blockade was assessed using the pin-prick method and also somatosensory evoked potentials (SEPs). A partial sympathetic blockade was seen during intrathecal, extradural and stellate ganglion blockade in most cases according to SRR-recordings. The haemodynamic parameters, cardiac output (CO), stroke volume (SV) and systemic vascular resistance (SVR) were well preserved, provided an i. v. pre-load infusion was given before and during onset of intrathecal blockade. There was no evidence of parasympathetic dominance causing hypotension during intrathecal blockade. The SEPs and SRRs were blocked in a similar way. For reliable assessment of sympathetic nerve block, it is necessary to evaluate the effect on both the sudomotor and vasoconstrictor fibres.
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