At Weber State University, in Ogden, Utah, Evan Call, MS, CSM (NRM) is Adjunct Faculty, Department of Microbiology; and Craig Oberg, PhD, is Faculty, College of Science. Laurie M. Rappl, PT, DPT, CWS, is President, Rappl & Associates, Simpsonville, South Carolina.
Adv Skin Wound Care. 2020 Oct;33(10S Suppl 1):S3-S10. doi: 10.1097/01.ASW.0000695744.57734.7c.
Turning and repositioning devices (TRDs) help to reduce strain on caregivers, but clinicians question their effects on humidity and temperature (microclimate) at the skin surface that may increase risk of pressure ulcers.
To pilot the use of a standard test for support surfaces to compare microclimate at the skin surface in three scenarios: (1) on a low-air-loss (LAL) surface, (2) on a representative TRD with a basic underpad (TRDU) placed on a LAL surface, and (3) on a negative control with full occlusion. The results are designed to inform clinical decision-making in using a TRD on a LAL surface and the viability of using this test to study TRDs.
Measuring humidity and temperature at the device-surface interface using a heated moisture-exuding bronze thermodynamic human model in a laboratory setting.
Humidity and temperature levels across 3 hours 15 minutes of continuous loading with a 45-second complete unloading to simulate a position change at 3 hours.
Relative humidity on the TRDU was below that on the LAL surface for the first 110 minutes and was markedly lower than the negative control for the remainder of humidity testing. Temperature on the TRDU was well below the negative control and negligibly higher than the surface alone throughout testing. The position change enhanced the effects of the TRDU.
The support surface standard test appears useful in evaluating TRDs. This TRD along with the basic underpad is more comparable to a LAL surface than to full occlusion in managing the microclimate of the skin and pressure ulcer risk.
翻身和重新定位设备(TRD)有助于减轻护理人员的负担,但临床医生对其对皮肤表面湿度和温度(微气候)的影响存在疑问,这些影响可能会增加压疮的风险。
试用标准的支撑面测试来比较三种情况下皮肤表面的微气候:(1)在低气流损失(LAL)表面上,(2)在放置在 LAL 表面上的代表性 TRD 和基本衬垫(TRDU)上,以及(3)在完全闭塞的负对照上。这些结果旨在为在 LAL 表面上使用 TRD 提供临床决策依据,并为使用该测试研究 TRD 的可行性提供依据。
在实验室环境中使用加热的散发水分的青铜热力学人体模型测量设备表面接口处的湿度和温度。
在连续加载 3 小时 15 分钟并在 3 小时进行 45 秒完全卸载的情况下,模拟位置变化,测量 3 小时内的湿度和温度水平。
在最初的 110 分钟内,TRDU 上的相对湿度低于 LAL 表面,并且在其余的湿度测试中明显低于负对照。在整个测试过程中,TRDU 上的温度远低于负对照,几乎与单独的表面温度相同。位置变化增强了 TRDU 的效果。
支撑面标准测试似乎在评估 TRD 方面有用。与完全闭塞相比,这种 TRD 与基本衬垫一起,在管理皮肤微气候和压疮风险方面,更类似于 LAL 表面。