School of Nursing & Midwifery, College of Science, Health and Engineering, La Trobe University, Melbourne, Victoria, Australia.
School of Nursing & Midwifery, College of Science, Health and Engineering, La Trobe University, Melbourne, Victoria, Australia.
J Tissue Viability. 2021 Aug;30(3):379-394. doi: 10.1016/j.jtv.2021.03.001. Epub 2021 Mar 6.
This study examined microclimate changes to the skin as a result of pressure over a 1 h period. The results were compared to skin parameter results following brief consecutive off-loading of pressure-prone areas.
A descriptive-correlational pilot study was undertaken.
A convenience sample of 41 healthy adults aged 18-60 years was recruited. Participants engaged in four 1 h data collection sessions. The sessions were conducted in both semi-recumbent and supine positions. Measures of erythema, melanin, stratum corneum hydration, and skin temperature were taken at pressure-prone areas at baseline and after 1 h in an uninterrupted method (continuous pressure-loading) and every 10 min in an interrupted method (brief off-loading). The Corneometer and Mexameter (Courage + Khazaka Electronics GMbH, 2013) and Exergen DermaTemp DT-1001 RS Infrared Thermographic Scanner (Exergen Corporation, 2008) provided a digital appraisal of skin parameters. Intraclass correlation coefficients (ICC) were calculated to indicate test-retest reliability and absolute agreement of results between the two methods.
Strong agreement between the interrupted and uninterrupted method was observed with ICCs ranging from 0.72 to 0.99 (supine) and 0.62-0.99 (semi-recumbent). Endpoint measures tended to be higher compared to baseline measures for all skin parameters. Differences in skin parameters results by anatomical location were evident particularly for erythema and stratum corneum hydration; the elbows and heels yielded lower scores compared to the sacrum. Erythema had the most variation across methods. The supine and semi-recumbent positions had negligible effect on measured skin parameters.
Minimal variation between skin parameter results indicates that brief off-loading in the interrupted method did not significantly change the outcomes; minor shifts in positioning do not alter changes to the skin from pressure. Skin parameters varied by anatomical location and changed over a 1 h period of pressure-loading.
Biophysical techniques may be able to assist accurate assessment of skin microclimate and skin colour. As brief off-loading (interruptions) to enable skin parameter measurement does not alter skin readings, researchers can proceed with some confidence regarding the use of this protocol in future studies assessing skin parameters. This study data provides a library of cutaneous changes at pressure-prone areas of healthy adults and is expected to inform innovative approaches to pressure injury risk assessment.
本研究旨在考察在 1 小时内压力导致的皮肤微气候变化。结果与压力易损区域短暂连续减压后的皮肤参数结果进行了比较。
进行了一项描述性相关性初步研究。
招募了 41 名年龄在 18-60 岁之间的健康成年人作为便利样本。参与者参加了四个 1 小时的数据收集会议。会议分别在半卧位和仰卧位进行。在基线和 1 小时时，采用不间断方法（连续加压）和每 10 分钟采用中断方法（短暂减压）在压力易损区域测量红斑、黑色素、角质层水分和皮肤温度。Corneometer 和 Mexameter（Courage + Khazaka Electronics GMbH，2013 年）和 Exergen DermaTemp DT-1001 RS 红外热成像扫描仪（Exergen Corporation，2008 年）提供了皮肤参数的数字评估。计算了组内相关系数（ICC）以表明两种方法的测试-重测可靠性和结果的绝对一致性。
中断法与不间断法之间观察到强烈的一致性，ICC 范围为 0.72 至 0.99（仰卧位）和 0.62-0.99（半卧位）。所有皮肤参数的终点测量值均高于基线测量值。皮肤参数结果的解剖位置差异明显，尤其是红斑和角质层水分；肘部和脚跟的得分低于骶骨。红斑在不同方法之间的变化最大。仰卧位和半卧位对测量的皮肤参数几乎没有影响。
皮肤参数结果之间的最小变化表明，中断法中的短暂减压并没有显著改变结果；位置的微小变化不会改变皮肤受到压力的变化。皮肤参数因解剖位置而异，并在 1 小时的加压过程中发生变化。
生物物理技术可能能够协助准确评估皮肤微气候和皮肤颜色。由于短暂减压（中断）以进行皮肤参数测量不会改变皮肤读数，因此研究人员可以对未来研究中使用该方案评估皮肤参数充满信心。本研究数据提供了健康成年人压力易损区域皮肤变化的库，并有望为压力性损伤风险评估的创新方法提供信息。
