Division of Basic & Clinical Medicine, Faculty of Nursing, Nagano College of Nursing, Komagane, Nagano 399-4117, Japan.
School of Nursing & Public Health, Yangzhou University, Yangzhou 225000, China.
Int J Mol Sci. 2022 Aug 11;23(16):8955. doi: 10.3390/ijms23168955.
Pressure injury (PI) prevention is a huge industry and involves various interventions. Temperature and moisture are important factors for wound healing; however, the active mechanism by which “moist heat” affects PI prevention has not yet been clarified. Thus, we explored the protective and therapeutic effects of hydrotherapy on PI based on the preconditioning (PC) principle, which might be useful for clinical practice. This study aimed to investigate the preventive mechanisms of heat shock preconditioning on PIs in rat models. The experiment was performed in the basic medical laboratory of Nagano College of Nursing in Japan. Ten rats were divided into two groups, with five rats in each group. Rats in the control group were not bathed. Rats in the preconditioning group (PC group) were bathed with hot tap-water. Bathing was conducted thrice a week. After bathing for 4 weeks, the PI model was constructed on the rats’ dorsal skin. The skin temperature, skin moisture, and area of ulcers were compared between the two groups. In vitro, we investigated the expression of heat shock protein 27 (Hsp27) in 6, 12, and 24 h after the PI model was constructed through Western blot analysis. Ulcers occurred in the control group 24 h after the PI model constructed, wheras the PC group exhibited ulcers after 36 h. The ulcer area was larger in the control group than that in the PC group after 24 h (all p < 0.05). The temperatures of PI wounds in the control group decreased and were lower than those in the PC group after 1, 6, 12, 36, and 48 h (all p < 0.05). However, the skin moisture levels of PI wounds increased in the control group and were higher than those in the PC group at the same time (all p < 0.05). Using Western blot analysis, hydrotherapy preconditioning showed the potential to increase Hsp27 expression after pressure was released (p < 0.05). We determine that heat shock preconditioning had a preventive effect on PIs in rat models, a result that may be associated with their actions in the upregulation of Hsp27.
压力性损伤（PI）预防是一个庞大的产业，涉及各种干预措施。温度和湿度是伤口愈合的重要因素；然而，“湿热”影响 PI 预防的主动机制尚未阐明。因此，我们基于预处理（PC）原则探索了水疗对 PI 的保护和治疗作用，这可能对临床实践有用。本研究旨在探讨热休克预处理对大鼠 PI 的预防机制。实验在日本长野护理学院的基础医学实验室进行。将 10 只大鼠分为两组，每组 5 只。对照组大鼠不洗澡。预处理组（PC 组）大鼠用热水洗澡。每周洗澡 3 次。洗澡 4 周后，在大鼠背部皮肤构建 PI 模型。比较两组大鼠的皮肤温度、皮肤水分和溃疡面积。在体外，通过 Western blot 分析研究了 PI 模型构建后 6、12 和 24 h 时热休克蛋白 27（Hsp27）的表达。PI 模型构建后 24 h 时对照组出现溃疡，而 PC 组则在 36 h 时出现溃疡。24 h 时对照组溃疡面积大于 PC 组（均 p < 0.05）。PI 伤口的温度在 1、6、12、36 和 48 h 后在对照组中降低且低于 PC 组（均 p < 0.05）。然而，PI 伤口的皮肤水分在对照组中增加，同时高于 PC 组（均 p < 0.05）。通过 Western blot 分析，水疗预处理在释放压力后显示出增加 Hsp27 表达的潜力（p < 0.05）。我们确定热休克预处理对大鼠 PI 模型具有预防作用，这一结果可能与其上调 Hsp27 的作用有关。
