Exploring the prevalence of skin tears and skin properties related to skin tears in elderly patients at a long‐term medical facility in Japan

Abstract

The identification of appropriate skin tear prevention guidelines for the elderly requires clinicians to focus on local risk factors such as structural alterations of the epidermis and dermis related to skin tears. The aim of this cross-sectional study is to explore the prevalence of skin tears and to explore skin properties related to skin tears in elderly Japanese patients at a long-term medical facility. After doing the prevalence study, 18 participants with skin tears and 18 without were recruited and an evaluation of their skin properties using 20-MHz ultrasonography, skin blotting and also Corneometer CM-825, Skin-pH-meterPH905, VapoMeter, Moisture Meter-D and CutometerMPA580 was undertaken. A total of 410 patients were examined, the median age was 87 years and 73·2% were women. The prevalence of skin tears was 3·9%, and 50% of skin tears occurred on the dorsal forearm. The changes in skin properties associated with skin tears included increased low-echogenic pixels (LEP) by 20-MHz ultrasonography, decreased type IV collagen and matrix metalloproteinase-2, and increased tumour necrosis factor-α by skin blotting. In conclusion, this study suggests that increased dermal LEP, including solar elastosis, may represent a risk factor for skin tears; this indicates that skin tear risk factors might not only represent chronological ageing but also photoageing.

Development of an improved method for quantitative analysis of skin blotting: increasing reliability and applicability for skin assessment

“…This method may strengthen the quantitative performance of skin blotting, which may expand the applicability of this method as a skin assessment tool in broader fields, such as nursing and cosmetology. reported that the skin of obese people is continuously exposed to oxidative stress, collagen-degrading enzymes [15], and inflammatory cytokines, e.g., tumor necrosis factor-α (TNF-α), all of which may be linked to skin weakness [16][17][18][19][20]. In another instance, skin maceration caused by incontinence leads to incontinence-associated dermatitis, which can be prevented by assessing the reduction of skin barrier function using a simple skin assessment tool [21].…”

“…Under these circumstances, several types of non-invasive skin assessment tools have been thus developed using laser analysis factor-β, and matrix metalloproteinase-2) in the dermis and epidermis can leak by diffusion through the epidermis and follicles when the skin is slightly macerated [18, 27]. In this method, a prewetted nitrocellulose membrane is patched to the region of interest on the skin, which creates a slightly macerated state.…”

“…Skin blotting is a non-invasive and easy-to-handle method, which can evaluate the soluble [18]. It has been reported that skin frailty is closely related to the degree of oxidative stress [16,19] and skin inflammation with cytokine secretion [11,18,28,33], and that such deteriorations were caused by obesity [16,20,34] and aging [18], both of which are now increasing worldwide.…”

“…For example, a mouse model for obesity has shown severe difficulties, involving wound healing [10,11] and the same has been equally true for human subjects [12]; obese subjects may have a higher prevalence of pressure ulcers [13] and a number of studies have reported the association between obesity and psoriasis [14]. Furthermore, it has been reported that the skin of obese people is continuously exposed to oxidative stress, collagen-degrading enzymes [15], and inflammatory cytokines, e.g., tumor necrosis factor-α (TNF-α), all of which may be linked to skin weakness [16][17][18][19][20]. In another instance, skin maceration caused by incontinence leads to incontinence-associated dermatitis, which can be prevented by assessing the reduction of skin barrier function using a simple skin assessment tool [21].…”

“…In another instance, skin maceration caused by incontinence leads to incontinence-associated dermatitis, which can be prevented by assessing the reduction of skin barrier function using a simple skin assessment tool [21]. From these findings, it may be important to assess the property of skin in a biochemical manner before the appearance of obvious drawbacks such as wound development that may affect the quality of life.Under these circumstances, several types of non-invasive skin assessment tools have been thus developed using laser analysis factor-β, and matrix metalloproteinase-2) in the dermis and epidermis can leak by diffusion through the epidermis and follicles when the skin is slightly macerated [18, 27]. In this method, a prewetted nitrocellulose membrane is patched to the region of interest on the skin, which creates a slightly macerated state.…”