A comparative study was made on four related factors of pressure ulcers healing in the exudates of hydrocolloid dressing（HCD）and food wrap. The concentration of basic fibroblast growth factor（bFGF）which promotes vascular growth and activation of fibroblast cells was measured. At the same time, comparisons were made of pH, temperature, bacteria and fungus. Two groups were established for the application of the occulusive materials. In Group A, HCD was used for one week followed by wrap for one week in 8 cases. In Group B, wrap was used for one week followed by HCD for one week in 11 cases. The exudate was collected one week after each application in each group. The results of this comparison showed that the concentration of bFGF was significantly higher in both groups in HCD（Group A; P=0.036, Group B; P=0.003）and pH was significantly lower in HCD（P<0.001）. The temperature averaged 35.3℃ in both groups with no difference between the two. The bacteria and fungua count were high in both groups,（Candida albicans, methicillin-resistant Staphylococcus aureus, Pseudomonas aeruginosa and Enterobacteriaceae）. In comparison of the four factors, at bFGF and pH, the effect of pressure ulcers healing was considered to be higher in HCD than in wrap.
We developed a care protocol for voluntary voiding and assessed its clinical utility in cerebrovascular disease patients with voiding dysfunction after indwelling urinary catheter removal. We studied cerebrovascular disease patients admitted to a cerebrovascular specialty hospital, in whom a urinary catheter had been placed for more than 7 days. The protocol comprised three phases: 1st: risk assessment of voiding dysfunction and decision-making for catheter removal; 2nd: removal of the catheter and care on the removal day; and 3rd: care for voluntary voiding. Voiding dysfunction was assessed using a portable ultrasound scanning device for bladder volume measurement, and the volumes of voiding, incontinence and residual urine, and voiding time and frequency were monitored. The primary outcome measures were the period of voiding dysfunction due to voiding approach, urinary retention and difficulty in voiding at discharge, which were assessed at the day of catheter removal, 1 week and 4 weeks later, and at the time of voluntary voiding. Intervention was conducted according to the protocol in collaboration with multidisciplinary staff, including the investigator, ward nurses, primary physician, specialty physician and rehabilitation staff. The subjects were 11 males and 6 females（mean age: 68.3 ± 13.5）. The period of catheter indwelling was 25.7 ± 15.9 days. Using the protocol, 13 of the 17 patients achieved voluntary voiding, and four needed an indwelling catheter again. Of the 13 patients who achieved voluntary voiding, seven achieved voiding in a toilet or urinary apparatus, and six experienced incontinence in diapers. These results suggest a certain benefit of the protocol.