The microclimate under dressings applied to intact weight-bearing skin: Infrared thermography studies

When a patient is lying in a hospital bed (e.g. supine or prone), bodyweight forces distort soft tissues by compression, tension and shear, and may lead to the onset of pressure ulcers in those who are stationary and insensate, especially at their pelvic region. Altered localized microclimate condit...

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Bibliographic Details
Published in:Clinical biomechanics (Bristol) 2020-05, Vol.75, p.104994-104994, Article 104994
Main Authors: Amrani, Golan, Peko, Lea, Hoffer, Oshrit, Ovadia-Blechman, Zehava, Gefen, Amit
Format: Article
Language:English
Subjects:
Bandages
Heat trapping
Humans
Infrared Rays
Male
Pressure
Pressure injury
Pressure ulcer risk assessment
Prevention
Prophylactic dressings
Skin Physiological Phenomena
Skin Temperature
Supine Position
Thermography
Weight-Bearing
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Summary:When a patient is lying in a hospital bed (e.g. supine or prone), bodyweight forces distort soft tissues by compression, tension and shear, and may lead to the onset of pressure ulcers in those who are stationary and insensate, especially at their pelvic region. Altered localized microclimate conditions, particularly elevated skin temperatures leading to perspiration and resulting in skin moisture or wetness, are known to further increase the risk for pressure ulcers, which is already high in immobile patients. We have used infrared thermography to measure local skin temperatures at the buttocks of supine healthy subjects, to quantitatively determine, for the first time in the literature, how skin microclimate conditions associated with a weight-bearing Fowler's position are affected by application of dressings. Our present methodology has been applied to compare a polymeric membrane dressing versus placebo foam, with a no-dressing case used as reference. One hour of lying in a Fowler's position was already enough to cause considerable heat trapping (~3 °C rise) between the weight-bearing body and the support surface. Analyses of normalized local skin temperatures and entropy of the temperature distributions indicated that the polymeric membrane dressing material allowed better and more homogenous clearance of locally accumulated body-heat with respect to simple foam. Infrared thermography is suitable for characterizing skin microclimate conditions under different dressings, and, accordingly, is effective in developing and evaluating pressure ulcer prevention and treatment strategies - both of which require adequate skin microclimate. •Infrared thermography is suitable for characterizing the skin microclimate•Heat produced by a supported body accumulates under dressings applied to skin•The body-produced accumulated heat may compromise skin health and integrity•Weight-bearing, dressing-covered skin temperatures measured by infrared thermography•Polymeric membrane dressings clear the body-produced heat better than foam
ISSN:0268-0033
1879-1271
DOI:10.1016/j.clinbiomech.2020.104994