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Integumentary Physical Therapy
피부계 물리치료학
Dong-Ryul Lee, PT, Ph.D. Movement Impairment Specialist
& Performance Enhancement Specialist
Neurofeedback, Robotics & Virtual Reality Research
Specialites: NeuroRehabilitation & Pediatric Rehabilitation
Skin (피부)
Wound (상처)
Wounds : Venous Ulcer (정맥부전궤양)
Wounds : Venous Ulcer
Wounds : Venous Ulcer
Wounds : Venous Ulcer
• Etiology • associated with
chronic venous insufficiency; • valvular
incompetence history of DVT,
• venous hypertension. By Vein
dysfunction (정맥부전) - 정맥 혈액 역류, 협착 or 혈전으로인한 정맥 혈류 폐색
By Muscle pump failure
(근육 펌프 기능 상실) - Calf m. (장딴지근육)
• Etiology • associated with
chronic venous insufficiency; • valvular
incompetence history of DVT,
• venous hypertension. By Vein
dysfunction (정맥부전) - 정맥 혈액 역류, 협착 or 혈전으로인한 정맥 혈류 폐색
By Muscle pump failure
(근육 펌프 기능 상실) - Calf m. (장딴지근육)
Wounds : Venous Ulcer
• Location • can occur
anywhere in lower leg; • common over
area of medial malleolus,
• sometimes lateral.
Wounds : Venous Ulcer
Wounds : Venous Ulcer
TABLE 5·3 •TRANSMISSION-BASED PRECAUTIONS
• Risk Factors • Vein dysfunction (정맥 기능부전)
• Muscle pump failure (근육펌프 상실)
Calf muscles
• Trauma (외상)
• History (정맥부전궤양 과거력)
재발률 81%
• Age (노령)
• Diabetes (당뇨)
Wounds : Venous Ulcer
• Clinical features • Pulses: normal. • Pain: none to aching pain in dependent
position. • Color:
normal or cyanotic in dependent position.
Dark pigmentation may appear, lipo-sclerosis (thick, tender, indurated, fibrosed tissue).
• Temperature: normal. • Edema: present, often marked. • Skin changes: pigmentation, stasis
dermatitis may be prevent; thickening of skin as scarring develops.
• Ulceration: may develop, especially medial ankle; wet, with large amount of exudate.
• Gangrene: absent.
Wounds : Venous Ulcer
• Characteristic
Wounds : Venous Ulcer
• Tests
Wounds : Venous Ulcer
• Management (Treatment)
Wounds : Venous Ulcer
• Management (Treatment)
Wounds : Venous Ulcer
• Physical Therapeutic Intervention
운동치료 물리치료 의학적 처치
활동중심중재 약물, 수술
• 보행 및 가동성 훈련 (Gait & Mobility Training)
• 운동범위운동 (ROM Ex.)
• 유산소운동 (Aerobic Ex.)
호흡 깊이/호흡수 증가 호흡펌프 효과 향상
장딴지 근육 펌프 효과 향상
비만or 혈당조절 상처치유능력 향상
• 연고함유붕대 감기
• 다층-압박붕대 감기
• 보조기형 압박장치
• 원통형 압박붕대
• 압박 스타킹
• 공기압박 치료
• 약물치료 - 펜톡시필린(Trental)
• 섬유소용해제 • 정맥부전궤양 치유
Good - 스테로이드
• 상처치유지연 • 전신투여 제한해야 함
• 외과수술 - 죽은조직제거 - 피부이식 (Skin graft) &
피부대체물 - 정맥수술 : 정맥묶음(vein ligation), 정맥제거술(V. stripping) 등
Wounds : Venous Ulcer
• Physical Therapeutic Intervention
Wounds : Venous Ulcer
• Physical Therapeutic Intervention
Wounds : Venous Ulcer
• Physical Therapeutic Intervention
Wounds : Venous Ulcer
• Physical Therapeutic Intervention
Wounds : Venous Ulcer
• Physical Therapeutic Intervention
Wounds : Venous Ulcer
• 피부물리치료학, 이재형 외, 정담미디어, 2013
• 피부물리치료중재학, 박지환, 범문에듀케이션, 2013
참고 문헌
Dong-Ryul Lee, PT, Ph.D.
Copyright by Dong-Ryul Lee, PT, Ph.D.
