Schubert V, Perbeck L, Schubert P A
Department of Geriatric Medicine, Karolinska Institutet, Huddinge University Hospital, Sweden.
Clin Physiol. 1994 Jan;14(1):1-13. doi: 10.1111/j.1475-097x.1994.tb00484.x.
Elderly subjects are prone to develop pressure sores over the sacrum area mainly due to external pressure and shear effects which negatively affect the skin microcirculation. The aim of the study described here was to measure skin microcirculatory and thermal changes in twelve elderly patients with an early stage of pressure sore and in ten elderly subjects without pressure sore. The total skin microcirculation at a damaged risk area, the sacrum, and a reference area of undamaged skin over the gluteal region, was evaluated using the laser Doppler fluxmetry. The nutritive transport of small solutes, characterized by the transcapillary exchange of sodium fluorescein, was evaluated using the fluorescein flowmetry technique. The skin temperature was measured with a thermoelement. The skin microcirculation at the area with an early stage of pressure sore was significantly higher than at undamaged skin as measured by both techniques. The total microcirculatory blood flow increased > 16 times (P < 0.001) and the nutritive transport approximately 5 times (P < 0.01) compared to the reference value, and the calculated blood flow of subpapillary tissue layers increased 17-19 times (P < 0.001). However, the skin temperatures in damaged and undamaged skin did not differ significantly. These results show an increased skin microcirculation in the early stage of pressure sores but no increase in skin temperature. The more strongly increased skin blood flow in subpapillary tissue layers effectively conducts away the heat caused by the damage and the increased metabolic activity.
老年受试者骶骨区域容易出现压疮，主要是由于外部压力和剪切力对皮肤微循环产生负面影响。本文所述研究的目的是测量12名早期压疮老年患者和10名无压疮老年受试者的皮肤微循环和热变化。使用激光多普勒血流仪评估受损风险区域（骶骨）以及臀区未受损皮肤参考区域的总皮肤微循环。使用荧光素血流仪技术评估以荧光素钠跨毛细血管交换为特征的小溶质营养转运。用热电偶测量皮肤温度。两种技术测量结果均显示，早期压疮区域的皮肤微循环显著高于未受损皮肤。与参考值相比，总微循环血流量增加超过16倍（P < 0.001），营养转运增加约5倍（P < 0.01），乳头下组织层计算出的血流量增加17 - 19倍（P < 0.001）。然而，受损皮肤和未受损皮肤的温度没有显著差异。这些结果表明压疮早期皮肤微循环增加，但皮肤温度未升高。乳头下组织层中更强的皮肤血流增加有效地带走了由损伤和增加的代谢活动引起的热量。
