Patterns and associations of structural and functional cutaneous responses during loading at heel and sacral skin in aged females: A reanalysis of clinical study data

Pfannes, Eva K. B.; Blume-Peytavi, Ulrike; Kottner, Jan

doi:10.1016/j.jtv.2018.05.003

Cited by 8 publications

(25 citation statements)

References 37 publications

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“…This interpretation is supported by results from a similar comparison after lying for 1 hour on a standard foam mattress with and without different dressings 18 . The baseline median sacral SCH ranging from 24.8 to 30.1 AU was similar to previous baseline estimates in a comparable setting 23,24 . After 3.5 hours loading there was an increase in all four groups indicating the accumulation of water molecules in the stratum corneum caused by occlusion.…”

Section: Discussionsupporting

confidence: 72%

“…Especially, the repeated backrest elevation induces friction to the sacral skin area and high degrees of mechanical deformation 35 . Compared to similar simulation studies in this area 23,24,26 a loading period of 3.5 hours was very long.The baseline sacral skin temperature of approximately 30°C was within the typical skin temperature range between 29°C and 31°C reported in comparable previous studies 15,24 . The skin temperature increased in all four groups, indicating occlusion and accumulation of heat.…”

Section: Discussionmentioning

confidence: 90%

“…Next to the “hard” clinical outcome “PU development”, a number of alternative biomarkers and parameters that characterize the response of the skin to prolonged loading and deformation have been proposed to evaluate the effectiveness of PU preventive interventions 20,21 . Skin functional parameters such as erythema or stratum corneum hydration (SCH) and structural parameters, like structural stiffness, have been successfully measured in previous PU prevention research 22,23 . These parameters are able to discriminate effects of different loading intensities and skin‐support surface interactions to measure PU preventive device performance 24 .…”

Section: Introductionmentioning

confidence: 99%

“…These parameters are able to discriminate effects of different loading intensities and skin‐support surface interactions to measure PU preventive device performance 24 . Recently, it has been shown that there are associations between structural and functional skin changes at the heel and sacral area during loading 23 . In clinical PU research, it has also been shown that (subclinical) injuries to the skin stimulate the release of inflammatory cytokines such as IL‐1α.…”

Section: Introductionmentioning

confidence: 99%

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Comparing the effects of three different multilayer dressings for pressure ulcer prevention on sacral skin after prolonged loading: An exploratory crossover trial

Lechner

Rancan

Hadam

et al. 2020

Wound Repair Regeneration

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Evidence suggests that preventive dressings applied on sacral skin help to prevent pressure ulcers. However, possible performance differences of different dressing types are unclear. An exploratory randomized crossover trial with intra‐individual comparisons was conducted to compare the effects of three different multi‐layer foam dressings (Mepilex Border Sacrum, ALLEVYN Life Sacrum and Optifoam Gentle Sacrum) compared to no dressing on the sacral skin. Healthy female volunteers (n = 12, mean age 72 years) wore three different dressings on their sacral skin for 3.5 hours while lying supine on a standard hospital mattress. At regular intervals, subjects performed standardized movements to enhance shear loads. Skin surface temperature, stratum corneum hydration, erythema, skin roughness and the interleukin 1 alpha (IL‐1α) concentration per total protein were measured at baseline and after the lying periods. After 3.5 hours, the median skin temperature increased in all four groups between 3.0°C and 3.8°C with only minor differences between the no dressing and the dressing groups. Median stratum corneum hydration increased during the lying period in all groups with highest increases in the Optifoam Gentle Sacrum (7.3 arbitrary units) and no dressing group (7.0 arbitrary units). There was a median decrease of the mean roughness (Rz) in the Optifoam Gentle Sacrum group of −6.3 μm but no relevant changes in the other groups. After loading, the erythema index was highest in the ALLEVYN Life Sacrum and no dressing groups. Highest releases of IL‐1α were observed in the ALLEVYN Life Sacrum and Optifoam Gentle Sacrum groups, in the Mepilex Border Sacrum group changes were minor. Study results indicate, that the application of preventive dressings on sacral skin during loading do not cause additional occlusion compared to loading without dressings when lying supine. Different dressings cause different cutaneous responses during loading.

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Section: Discussionsupporting

confidence: 72%

Section: Discussionmentioning

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Comparing the effects of three different multilayer dressings for pressure ulcer prevention on sacral skin after prolonged loading: An exploratory crossover trial

Lechner

Rancan

Hadam

et al. 2020

Wound Repair Regeneration

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View full text Add to dashboard Cite

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“…Research regarding skin and tissue assessment and early detection of pressure injury is advancing [63]. More recent advances include bioengineering techniques to measure skin and tissue status during and after loading such as transepidermal water loss [63,64], skin and tissue hydration [63,65], (skin) blood flow [66][67][68], skin markers such as interleukins [66,69], microclimate measurements [63,70], ultrasound to detect edema and structural tissue changes [71,72], and infrared Table 2 Key considerations for investigating measurement properties of pressure ulcer/injury classification. • COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN) [45] • • COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN) [45] thermography to detect warm areas indicative of tissue inflammation and cold areas indicative of tissue death [73,74].…”

Section: What Next?mentioning

confidence: 99%