Lechner Anna, Rancan Fiorenza, Hadam Sabrina, Vogt Annika, Blume-Peytavi Ulrike, Kottner Jan
Department of Dermatology, Venereology and Allergy, Clinical Research Center for Hair and Skin Science, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Charité Center Health and Human Sciences, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Wound Repair Regen. 2021 Mar;29(2):270-279. doi: 10.1111/wrr.12883. Epub 2020 Dec 21.
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.
有证据表明，应用于骶部皮肤的预防性敷料有助于预防压疮。然而，不同类型敷料可能存在的性能差异尚不清楚。本研究进行了一项探索性随机交叉试验，并进行个体内比较，以比较三种不同的多层泡沫敷料（美皮康骶部边框型、爱立肤骶部型和优倍肤温和骶部型）与不使用敷料对骶部皮肤的影响。12名健康女性志愿者（平均年龄72岁）仰卧在标准医院床垫上时，在其骶部皮肤上佩戴三种不同的敷料3.5小时。受试者定期进行标准化动作以增加剪切力。在基线和卧床期后，测量皮肤表面温度、角质层水合作用、红斑、皮肤粗糙度以及每总蛋白中白细胞介素1α（IL-1α）的浓度。3.5小时后，所有四组的皮肤温度中位数均升高了3.0°C至3.8°C，未使用敷料组和使用敷料组之间仅有微小差异。所有组在卧床期间角质层水合作用中位数均增加，其中优倍肤温和骶部型组（7.3任意单位）和未使用敷料组（7.0任意单位）增加最多。优倍肤温和骶部型组的平均粗糙度（Rz）中位数下降了6.3μm，而其他组无相关变化。加载后，爱立肤骶部型组和未使用敷料组的红斑指数最高。爱立肤骶部型组和优倍肤温和骶部型组观察到IL-1α释放量最高，美皮康骶部边框型组变化较小。研究结果表明，仰卧卧床时，与不使用敷料相比，在骶部皮肤上应用预防性敷料在加载过程中不会导致额外的闭塞。不同的敷料在加载过程中会引起不同的皮肤反应。
