The purpose of this study was to investigate early postoperative skin trouble in patients with Crohn’s Disease after ileostomy surgery. Forty patients who underwent ileostomy surgery for bowel obstruction or perforation were studied. First preoperative serum total protein and albumin levels, daily stool volume and stool consistency, and peristomal skin trouble were evaluated retrospectively. Serum total protein and albumin levels decreased during the first week after surgery and returned to the preoperative level in the third week post-op. Initial stool passage was recorded by the fourth day after surgery in all patients, and almost all patient had liquid stool. Mean stool volume increased gradually（postoperative first day: 339g, 14th day: 1202g respectively）. The most frequent skin trouble was skin erosion（61.5%）which was due to irritation from contact with stool. No significant correlation was found between total protein or albumin levels, daily stool volume, and the incidence of skin touble. We found that peristomal skin touble associated with liquid stool or ostomy appliances frequently developed in the early postoperative period. Adequate stoma care is necessary to prevent skin trouble after ileostomy surgery in patients with Crohn’s Disease.

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　Pressure ulcer prevention for home care clients is not accomplished by visiting only. Collaborative efforts by all irivolved care givers are required.
　A questionnaire survey of pressure ulcer awareness was conducted among care givers using Saiseikai Visiting Nurse Stations across the country in order to study their knowledge of pressure ulcers and preventive measures.
　Out of 523 responses, 18.5% of home care clients suffered from pressure ulcers. Although 89.9% of care givers knew the word “bedsore (pressure ulcer)”. 21.2% of care givers did not know about its causes. 40.3% of care givers were not instructed how to prevent pressure ulcers, and 22.8% of care givers did not use any nursing care supplies for prevention. Among the care givers who had received preventive education, 14.0% of them did not practice what they had learned. At the same time, it has become clear that all medical workers whose responsibility is to educate home healthcare personal, including both doctors and nurses do not necessarily have appropriate knowledge of pressure ulcers and how to prevent them.
　To prevent pressure ulcers among home care clients, the education of their care givers including proper technical guidance is indispensable. Teaching methods should be well understood and easy to practice even by the elderly care givers, while preventive education aimed at medical workers is also needed.

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　The rate of incidence and improvement of urinary incontinence was investigated though questionnaires sent to 1000 healthy Japanese women aged 25 to 79 years. Among the 806 returned surveys we found that 338 women had experienced urinary incontinence. 221 of those who had experienced some form of urinary incontinence had subsequently improved. Results indicate that the incidence of urinary incontinence is highest among women who have experienced childbirth and/or have a high Body Mass Index (BMI) score. Problems with urinary incontinence tend to continue most often among women who have had abdominal surgery. We found that abdominal surgery was one of the factors of urinary incontinence.

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　The following is a report on the activities and results of Wound Ostomy Continence (WOC) Nursing certified expert nurses. It is also a survey by questionnaire and case reports of individual WOC nurses and their immediate superior(s) six months after certification. The results suggest the following: (1) Characteristic activities of WOC nurses: (a) They often care for limited physical problems in their direct care. (b) They instruct and consult staff nurses. (c) Medical doctors often consult them. (2) The result of WOC nurses’ care for patients, health service professionals and their hospitals, in general, include the following: (a) Limited partial physical recovery psychiatric by their care. (b) Solutions to physical problems have had positive effects. (c) Educational activities such as instructions regarding nursing procedure and record keeping have had a positive influence on quality and efficiency in hospitals. (d) WOC nurses are effective for improving nursing quality as a whole thanks to their good assessment and evaluation of care. (e) WOC nurses lift the moral of nursing staffs, and they make a contribution to the management of their hospitals.

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　To confirm the effectiveness of bathing to improve pressure ulcers, local skin blood flow, bacterial flora and skin pH were compared between the periods before and after bathing in elderly patients with pressure ulcers, aged 61-90 hospitalized in a so called “care-management intensified hospital.” The local blood flow was measured at the skin area directly surrounding the ulcer and 1.5cm distant from the edge of the ulcer by non-detachment laser-flowmetry. Bacterial flora were collected by using the swab method on the skin directly surrounding the ulcer and 1.5cm distant from the edge of the ulcer before and after bathing, and also before and after cleansing during dressing changes. The skin pH was measured at points 1.5cm and 10cm distant from the edge of the ulcer and scapula area before, immediately after, and also 2 hours and 5 hours after bathing. We found that skin blood flow increased significantly within two hours after bathing in all four cases. The changes of blood flow after bathing at areas 1.5cm distant from the pressure ulcer were different between the group with normal skin and those with scarred skin. The bacterial flora decreased after bathing at each site compared to cleansing at dressing changes. The skin pH was not different before and after bathing. These results show that the effectiveness of bathing to improve pressure ulcers might be partially due to an increase of blood flow and decrease of bacterial flora especially in patients who have scars surrounding their pressure ulcers.

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