Method
Thirteen cases with stage IV pressure ulcers (according to the National Pressure Ulcer Advisory Panel, 1989) were enrolled for the study. Seven cases were treated with Ulmus and 6 cases were treated with wet gauze as a control group. The sizes and stages of pressure ulcers were evaluated every 2 week for 12 weeks.

Results
After 12 weeks, the size of pressure ulcers decreased from 78.17⁑47.77 cm³ to 8.14⁑13.17 cm³ (mean⁑S.D., n=7) in Ulmus treated group, whereas from 62.10⁑40.89 cm³ to 36.69⁑36.23 cm³ (mean⁑S.D., n=6) in wet gauze treated group. The size of pressure ulcers decreased more significantly (p＜0.05) in Ulmus treated group than wet gauze dressed group. Among seven cases treated by Ulmus, 2 cases completely healed, 3 cases improved to stage II, and 2 cases remained to stage IV, whereas among 6 cases treated by wet gauze, 1 cases improved to stage II, 1 case to stage III, and 4 cases remained to stage IV.

Conclusion
Ulmus was more effective in management of pressure ulcers than wet gauze. We suggest that Ulmus can be used as a useful method of conservative treatment for the stage IV pressure ulcers. (J Korean Acad Rehab Med 2003; 27: 899-905)