Skin response to sustained loading: A clinical explorative study
Skin response to sustained loading: A clinical explorative study
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DOI：
10.1016/j.jtv.2015.04.002
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发表时间：
2015-08-01
影响因子：
2.5
通讯作者：
Blume-Peytavi, U.
中科院分区：
文献类型：
--
作者：
Kottner, J.;Dobos, G.;Blume-Peytavi, U.
背景：严重的疾病、残疾和不动会增加压疮发生的风险。压力性溃疡是由于长期承受压力和剪切而对皮肤和/或下层组织造成的局部损伤。角质层和上皮肤层在浅表性压疮发生中的作用知之甚少。Objective. Objectives：探讨两个压疮好发部位在临床条件下长期负荷对皮肤屏障功能的可能影响。在受控条件下，20只健康雌性（平均年龄69.9（3.4）岁）遵循标准化固定方案，在标准医院床垫上穿着医院睡衣，仰卧位固定90和150分钟。之前和之后立即加载期间皮肤表面温度，角质层水化，经皮水分流失和红斑进行了测量，在骶骨和足跟skin.Results：延长负荷引起皮肤表面温度和红斑在骶骨和足跟皮肤的增加。角质层水合作用保持稳定。经皮水分流失大幅增加后，负荷在脚跟，但不是在骶骨skin.Conclusions：皮肤功能的变化，在骶骨和脚跟皮肤在老年人长期负荷。热量积聚和充血似乎是导致皮肤温度升高和红斑的主要原因，而皮肤温度升高和红斑与压疮的发展有关。足跟部经表皮水分流失增加表明，在负荷期间，足跟部角质层出现亚临床损伤，但骶骨皮肤未出现亚临床损伤，这表明两个皮肤区域的压疮发展途径不同。(C)2015年组织活力协会。由爱思唯尔有限公司出版。保留所有权利。
Background: Severe illness, disability and immobility increase the risk of pressure ulcer development. Pressure ulcers are localized injuries to the skin and/or underlying tissue as a result of long enduring pressure and shear. Little is known about the role of the stratum corneum and the upper skin layers in superficial pressure ulcer development.Objectives: To investigate possible effects of long enduring loading on the skin barrier function under clinical conditions at two pressure ulcer predilection sites.Methods: Under controlled conditions 20 healthy females (mean age 69.9 (3.4) years) followed a standardized immobilization protocol of 90 and 150 min in supine position wearing hospital nightshirts on a standard hospital mattress. Before and immediately after the loading periods skin surface temperature, stratum corneum hydration, transepidermal water loss and erythema were measured at the sacral and heel skin.Results: Prolonged loading caused increases of skin surface temperature and erythema at the sacral and heel skin. Stratum corneum hydration remained stable. Transepidermal water loss increased substantially after loading at the heel but not at the sacral skin.Conclusions: Skin functions change during prolonged loading at the sacral and heel skin in aged individuals. Accumulation of heat and hyperaemia seem to be primarily responsible for increasing skin temperature and erythema which are associated with pressure ulcer development. Increased transepidermal water loss at the heels indicate subclinical damages of the stratum corneum at the heel but not at the sacral skin during loading indicating distinct pathways of pressure ulcer development at both skin areas. (C) 2015 Tissue Viability Society. Published by Elsevier Ltd. All rights reserved.