Department of Biomedical Engineering, Faculty of Engineering, Tel Aviv University, Tel Aviv 6997801, Israel.
School of Electrical Engineering, Afeka Tel-Aviv Academic College of Engineering, Tel-Aviv, Israel.
Clin Biomech (Bristol). 2020 May;75:104994. doi: 10.1016/j.clinbiomech.2020.104994. Epub 2020 Apr 21.
When a patient is lying in a hospital bed (e.g. supine or prone), bodyweight forces distort soft tissues by compression, tension and shear, and may lead to the onset of pressure ulcers in those who are stationary and insensate, especially at their pelvic region. Altered localized microclimate conditions, particularly elevated skin temperatures leading to perspiration and resulting in skin moisture or wetness, are known to further increase the risk for pressure ulcers, which is already high in immobile patients.
We have used infrared thermography to measure local skin temperatures at the buttocks of supine healthy subjects, to quantitatively determine, for the first time in the literature, how skin microclimate conditions associated with a weight-bearing Fowler's position are affected by application of dressings. Our present methodology has been applied to compare a polymeric membrane dressing versus placebo foam, with a no-dressing case used as reference.
One hour of lying in a Fowler's position was already enough to cause considerable heat trapping (~3 °C rise) between the weight-bearing body and the support surface. Analyses of normalized local skin temperatures and entropy of the temperature distributions indicated that the polymeric membrane dressing material allowed better and more homogenous clearance of locally accumulated body-heat with respect to simple foam.
Infrared thermography is suitable for characterizing skin microclimate conditions under different dressings, and, accordingly, is effective in developing and evaluating pressure ulcer prevention and treatment strategies - both of which require adequate skin microclimate.
当患者躺在医院病床上（例如仰卧或俯卧）时，体重会通过压缩、拉伸和剪切使软组织变形，可能导致静止和无知觉的患者（尤其是骨盆区域）出现压疮。已知局部微气候条件的改变，特别是导致出汗和皮肤水分或湿润的升高皮肤温度，会进一步增加压疮的风险，而对于不能活动的患者，这种风险已经很高。
我们使用红外热像仪测量仰卧健康受试者臀部的局部皮肤温度，首次在文献中定量确定与承重 Fowler 位相关的皮肤微气候条件如何受到敷料应用的影响。我们目前的方法已应用于比较聚合物膜敷料与安慰剂泡沫敷料，不使用敷料的情况作为参考。
仅在 Fowler 位躺一个小时就足以在承重身体和支撑表面之间造成相当大的热量积聚（升高约 3°C）。对归一化局部皮肤温度和温度分布熵的分析表明，聚合物膜敷料材料允许更好、更均匀地清除局部积累的体热，而简单的泡沫则不然。
红外热像术适合于表征不同敷料下的皮肤微气候条件，因此，它在开发和评估压疮预防和治疗策略方面是有效的，这两者都需要适当的皮肤微气候。
