The Influence of Environmental Temperature on the Response of the Skin to Local Pressure: The Impact of Aging and Diabetes

McLellan, Katie; Petrofsky, Jerrold S.; Zimmerman, Grenith; Lohman, Everett; Prowse, Michelle; Schwab, Ernie; Lee, Scott

doi:10.1089/dia.2009.0097

Cited by 22 publications

(32 citation statements)

References 33 publications

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“…This phenomenon -called reactive hyperaemia -serves to restore the normal metabolic state of the tissue as quickly as possible and normally lasts from 50% to 75% of the total ischemic period (Bliss, 1993;Popcock & Richards, 2006). As with PIV, the reactive hyperaemia function has been shown to be altered in the elderly (McLellan et al, 2009).…”

Section: Blood Flow Responses Related To Loadingmentioning

confidence: 99%

“…In addition, with advanced age the papilla become more flattened as the epidermis gradually thins and reduces the skin´s resistance to shearing forces (Stephen-Haynes, 2012). It is clear that blood flow responses such as PIV, vasodilation due to heat stress, and reactive hyperaemia tend to be significantly altered among the elderly (Ek et al, 1984;McLellan et al, 2009), but research on how blood flow responses among the elderly are affected by loading in different positions and over prolonged time is limited. Schubert and Heraud (1994) measured sacral skin blood flow with laser Doppler flowmeter over the course of 30 minutes in a 0 supine position and a 45 semi-Fowler position in two geriatric patient groups; one group had no or low risk for pressure ulcer development, and one group had high risk.…”

Section: Blood Flow Responses Among Elderly Patients In Different Posmentioning

confidence: 99%

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Evaluation of Repositioning in Pressure Ulcer Prevention

Källman¹

2015

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Section: Blood Flow Responses Related To Loadingmentioning

confidence: 99%

Section: Blood Flow Responses Among Elderly Patients In Different Posmentioning

confidence: 99%

Evaluation of Repositioning in Pressure Ulcer Prevention

Källman¹

2015

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“…The Pennes model also did not take into consideration skin moisture and subcutaneous fat, both of which alter conductive heat exchange [ 82,109 ] . In addition, aging and diabetes reduce skin blood fl ow [ 70,71,96 ] and may alter subcutaneous fat thickness and skin moisture, changing both conductive and bloodborne heat transfer.…”

Section: Modeling Of Heat Exchange Through the Skinmentioning

confidence: 99%

Skin Moisture and Heat Transfer

Petrofsky

Berk

2012

Treatment of Dry Skin Syndrome

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“…5,22,[41][42][43][44][45][46] This has its greatest effect on sympathetically mediated vasodilatation. 5,8,22,29,47 A common clinical measure of autonomic nervous system impairment is heart rate variability with the subject at rest. 22,48,49 Normally, vasomotor rhythm in the sympathetic and parasympathetic systems causes the heart rate to vary continuously, breath by breath, during respiration.…”

mentioning

confidence: 99%

“…Normally, when light pressure (up to 4 kPa) is applied to the skin, there is an increase in skin blood flow in people who do not have diabetes. 47,[58][59][60][61] This is a protective mechanism by which, especially during quiet standing, the pressure of the body on the feet does not reduce skin circulation and cause skin damage. When greater pressures are applied to the skin and released, skin circulation is diminished in proportion to the pressure followed by a reactive hyperemia in skin blood flow after the pressure is released.…”

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confidence: 99%

The Effect of Type-2-Diabetes-Related Vascular Endothelial Dysfunction on Skin Physiology and Activities of Daily Living

Petrofsky

2011

J Diabetes Sci Technol

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A common factor contributing to organ damage in type 2 diabetes mellitus (T2DM) is impaired tissue blood flow caused by damage to vascular endothelial cells (VECs). Damage can occur even before the clinical diagnosis of diabetes. It can be caused by both a high average blood glucose concentration and/or large daily spikes in blood glucose. While much of the present literature focuses on the damage to VECs and organs from these large glucose excursions, this review will focus on the consequence of this damage, that is, how endothelial cell damage in diabetes affects normal daily activities (e.g., exercise, reaction to typical stimuli) and various treatment modalities (e.g.. contrast baths and electrical stimulation therapy). It is important to understand the effects of VEC damage such as poor skin blood flow, compromised thermoregulation, and altered response to skin pressure in designing diabetes technologies as simple as heating pads and as complex as continuous glucose monitors. At the simplest level, people with diabetes have poor circulation to the skin and other organs. In the skin, even the blood flow response to locally applied pressure, such as during standing, is different than for people who do not have T2DM. Simple weight bearing on the foot can occlude the skin circulation. This makes the skin more susceptible to damage. In addition, endothelial damage has farreaching effects on the whole body during normal activities of daily living, including an impaired response to local heat, such as hot packs and contrast baths, and higher body temperatures during whole body heating due to impaired blood flow and a reduced ability to sweat. Finally, because of multiple organ damage, people with T2DM have poor balance and gait and impaired exercise performance. Technol 2011;5(3):657-667 J Diabetes Sci SYMPOSIUM OverviewType 2 diabetes mellitus (T2DM) is associated with serious consequences for health and mortality such as cardiovascular disease, renal disease, and stroke. 1,2 While different organ systems are impaired in people with diabetes, 3,4 a common factor in many of the complications of diabetes and the natural senescence of the organs due to aging is impaired vascular endothelial function. Diabetes is characterized by abnormally high vascular tone 6 and impaired vasorelaxation of blood vessels.7 Lack of a typical circulatory response to stress not only damages organs, but affects whole body functions such as balance, gait, and the ability to respond to heat stress. [8][9][10][11] 658 Many articles have focused on continuous glucose monitoring and its importance in preventing cellular damage in people with diabetes. [12][13][14] This review will concentrate on the implications of poor glucose control on blood flow and on how damage to vascular endothelial cells (VECs) impacts whole body function such as the ability of the skin to handle stressors during daily activities and more gross whole body functions such as thermoregulation, balance, orthostatic tolerance, and gait. Impact of Diabetes on ...

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The Influence of Environmental Temperature on the Response of the Skin to Local Pressure: The Impact of Aging and Diabetes

Abstract: The protective mechanism of PIV is severely reduced in older populations and those with diabetes, especially in colder environments where skin blood flow is already diminished.

Cited by 22 publications

References 33 publications

Evaluation of Repositioning in Pressure Ulcer Prevention

Evaluation of Repositioning in Pressure Ulcer Prevention

Skin Moisture and Heat Transfer

The Effect of Type-2-Diabetes-Related Vascular Endothelial Dysfunction on Skin Physiology and Activities of Daily Living

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