Microclimate and development of pressure ulcers and superficial skin changes

Yusuf, Saldy; Okuwa, Mayumi; Shigeta, Yoshie; Dai, Misako; Iuchi, Terumi; Rahman, S.; Usman, Awaluddin; Kasim, Sukmawati; Sugama, Junko; Nakatani, Toshio; Sanada, Hiromi

doi:10.1111/iwj.12048

Cited by 84 publications

(90 citation statements)

References 43 publications

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“…Skin microclimate studies showed that increased humidity, increased skin temperature, and reduced permeability of materials in skin contact increased the risk of superficial pressure ulcers (ie, stage II). 32,33 Our association of erythema with higher skin hydration is consistent with the predicted risk factors. The water vapor-permeable SleepWeaver mask resulted in decreased skin hydration relative to occlusive masks.…”

Section: Discussionsupporting

confidence: 84%

Face Masks for Noninvasive Ventilation: Fit, Excess Skin Hydration, and Pressure Ulcers

et al. 2015

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BACKGROUND: Pressure ulcers (stages III and IV) are serious safety events (ie, never events).Healthcare institutions are no longer reimbursed for costs to care for affected patients. Medical devices are the leading cause of pediatric pressure ulcers. Face masks for noninvasive ventilation were associated with a high percentage of pressure ulcers at our institution. METHODS: A prospective cohort study investigated factors contributing to pressure ulcer development in 50 subjects using face masks for noninvasive ventilation. Color imaging, 3-dimensional surface imaging, and skin hydration measurements were used to identify early skin compromise and evaluate 3 interventions to reduce trauma: (1) a silicone foam dressing, (2) a water/polyethylene oxide hydrogel dressing, and (3) a flexible cloth mask. A novel mask fit technique was used to examine the impact of fit on the potential for skin compromise. RESULTS: Fifty subjects age 10.4 ؎ 9.1 y participated with color images for 22, hydration for 34, and mask fit analysis for 16. Of these, 69% had diagnoses associated with craniofacial anomalies. Stage I pressure ulcers were the most common injury. Skin hydration difference was 317 ؎ 29 for sites with erythema versus 75 ؎ 28 for sites without erythema (P < .05) and smallest for the cloth mask (P < .05). Fit distance metrics differed for the nasal, oronasal, and face shield interfaces, with threshold distances being higher for the oronasal mask than the others (P < .05). Areas of high contact were associated with skin erythema and pressure ulcers. CONCLUSIONS: This fit method is currently being utilized to select best-fit masks from available options, to identify the potential areas of increased tissue pressure, and to prevent skin injuries and their complications. Improvement of mask fit is an important priority for improving respiratory outcomes. Strategies to maintain normal skin hydration are important for protecting tissue integrity.

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Section: Discussionsupporting

confidence: 84%

Face Masks for Noninvasive Ventilation: Fit, Excess Skin Hydration, and Pressure Ulcers

et al. 2015

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“…The direct contact of the skin with the linen and mattress reduces air convection leading to a local accumulation of heat [30,36]. In addition local compression and deformation of the skin and underlying soft tissues lead to changes in blood flow [37] and to pronounced hyperaemia after unloading [38] which again is associated with increasing skin temperature.…”

Section: Discussionmentioning

confidence: 99%

“…Elevated skin temperature seems to a play a major role in PU aetiology [28,39]. Experimental results indicate for instance a reduction of the cohesive strength of the SC integrity [29] and empirical evidence shows a strong association between increased skin temperature and the risk of skin breakdown [36,40,41].…”

Section: Discussionmentioning

confidence: 99%

Skin response to sustained loading: A clinical explorative study

Kottner

Dobos

Andruck

et al. 2015

Journal of Tissue Viability

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“…Continuous temperature monitoring of the skin can provide clinicians with useful information when investigating a variety of conditions, such as non-freezing cold injuries [4,5], the early detection of foot ulcers [6,7], or Raynaud's disease [8].…”

Section: Introductionmentioning

confidence: 99%

Developing Novel Temperature Sensing Garments for Health Monitoring Applications

Lugoda

Hughes‐Riley

Oliveira

et al. 2018

Fibers

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Embedding temperature sensors within textiles provides an easy method for measuring skin temperature. Skin temperature measurements are an important parameter for a variety of health monitoring applications, where changes in temperature can indicate changes in health. This work uses a temperature sensing yarn, which was fully characterized in previous work, to create a series of temperature sensing garments: armbands, a glove, and a sock. The purpose of this work was to develop the design rules for creating temperature sensing garments and to understand the limitations of these devices. Detailed design considerations for all three devices are provided. Experiments were conducted to examine the effects of contact pressure on skin contact temperature measurements using textile-based temperature sensors. The temperature sensing sock was used for a short user trial where the foot skin temperature of five healthy volunteers was monitored under different conditions to identify the limitations of recording textile-based foot skin temperature measurements. The fit of the sock significantly affected the measurements. In some cases, wearing a shoe or walking also heavily influenced the temperature measurements. These variations show that textile-based foot skin temperature measurements may be problematic for applications where small temperature differences need to be measured.

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Microclimate and development of pressure ulcers and superficial skin changes

Cited by 84 publications

References 43 publications

Face Masks for Noninvasive Ventilation: Fit, Excess Skin Hydration, and Pressure Ulcers

Face Masks for Noninvasive Ventilation: Fit, Excess Skin Hydration, and Pressure Ulcers

Skin response to sustained loading: A clinical explorative study

Developing Novel Temperature Sensing Garments for Health Monitoring Applications

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