A quantitative analysis of microcirculation in sore-prone pressure areas on conventional and pressure relief hospital mattresses using laser Doppler flowmetry and tissue spectrophotometry

Rothenberger, Jens; Krauß, Sabrina; Held, Manuel; Bender, Dominik; Schaller, Hans-Eberhard; Rahmanian-Schwarz, Afshin; Constantinescu, Mihai A.; Jaminet, Patrick

doi:10.1016/j.jtv.2014.05.001

Cited by 19 publications

(10 citation statements)

References 21 publications

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“…In fact, as tissue damage in the lateral thorax is unlikely to result in an increased skin temperature near the navel region due to the distance involved, we consider that it is valid to discuss, as described in this report, the possibility that the increased skin temperature preceded the tissue damage. Rothenberger et al investigated the heel area blood flow obtained using a standard hospital foam mattress bed, viscoelastic foam mattress and air‐fluidized bed and reported that only the air‐fluidized bed resulted in a maintained blood circulation . Accordingly, we consider that skin temperature, which masked the interface pressure and length of surgery, was extracted as a risk factor when an appropriate support surface was used because the influence of the interface pressure and length of surgery, which affect the blood flow, was weakened.…”

Section: Discussionmentioning

confidence: 96%

“…Rothenberger et al investigated the heel area blood flow obtained using a standard hospital foam mattress bed, viscoelastic foam mattress and air-fluidized bed and reported that only the air-fluidized bed resulted in a maintained blood circulation. 36 Accordingly, we consider that skin temperature, which masked the interface pressure and length of surgery, was extracted as a risk factor when an appropriate support surface was used because the influence of the interface pressure and length of surgery, which affect the blood flow, was weakened.…”

Section: Discussionmentioning

confidence: 99%

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Microclimate is an independent risk factor for the development of intraoperatively acquired pressure ulcers in the park‐bench position: A prospective observational study

Yoshimura

Nakagami

Iizaka

et al. 2015

Wound Repair Regeneration

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Preventing pressure ulcers is important in patients undergoing procedures in the park-bench position. We hypothesized that the microclimate around the skin is a significant risk factor for developing pressure ulcers. This research continuously assessed factors of the microclimate in terms of skin temperature and perspiration as well as the interface pressure in order to determine whether the microclimate is an independent risk factor for the development of park-bench position-related pressure ulcers (PBP-PUs). A prospective observational study was conducted among patients undergoing elective surgery in the park-bench position at a general hospital in the metropolitan area of Japan between April and November 2014. Factors of the microclimate, including skin temperature and perspiration, in addition to the interface pressure were continuously measured throughout surgery. Twenty-nine patients were analyzed (mean age 44.4 ± 13.2 years, male 44.8%). Of these 29 patients, seven (24.1%) developed Category I PBP-PUs. The change in skin temperature from baseline to the end of surgery (2.7 ± 0.3 °C vs. 1.9 ± 0.8 °C) and the average peak pressure (119.1 ± 36.8 mmHg vs. 94.5 ± 23.1 mmHg) were significantly higher in the patients with PBP-PUs than in those without PBP-PUs. There were no significant differences in the amount of perspiration between the two groups. A hierarchical logistic regression analysis showed that the change in skin temperature was significantly related to the development of PBP-PUs (unit = 0.1 °C: odds ratio 1.44, 95% confidential interval 1.09-2.33) when adjusted for the average peak pressure and length of surgery. Our results suggest that a change in skin temperature toward a higher value is an independent risk factor for the development of PBP-PUs. Proper intraoperative management of skin temperature may therefore be a promising candidate as a preventive method against PBP-PU development.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Microclimate is an independent risk factor for the development of intraoperatively acquired pressure ulcers in the park‐bench position: A prospective observational study

Yoshimura

Nakagami

Iizaka

et al. 2015

Wound Repair Regeneration

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“…This device quantifies the blood flow and the relative amount of hemoglobin, which represent mainly the capillary-venous compartment because most of the hemoglobin is located in the capillary and postcapillary system of the microvascular bed [14]. The measurements represent only the nutritive, microvascular vessels because the light is completely absorbed if the vessel diameter is greater than 100 mm [14].…”

Section: Discussionmentioning

confidence: 99%

“…The measurements represent only the nutritive, microvascular vessels because the light is completely absorbed if the vessel diameter is greater than 100 mm [14]. This device has been proven to be a reliable and valid tool in various conditions, such as microvascular flap monitoring [15], flap microperfusion [16], skin perfusion in sore-prone pressure areas [14], determining the need for medical leeches in congested tissues [17], and microcirculatory changes of cold contact injuries [18]. …”

Section: Discussionmentioning

confidence: 99%

Skin Perfusion Changes within 12 h after Axillary Plexus Block

et al. 2017

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Background/Purpose: An improvement of the blood flow would be beneficial in microvascular upper-extremity reconstruction and in digit replantation. In the present work, skin perfusion changes and their duration due to axillary plexus block were quantified. Methods: The peripheral blood flow of the upper extremities in 20 patients undergoing trapeziectomy under axillary plexus block was analyzed. Results: Laser Doppler spectrophotometry was used to measure perfusion factors over a 12-h period, with the contralateral hand acting as the control. Axillary plexus block produced a significant increase of peripheral oxygen saturation (117 ± 35% vs. control 93 ± 22%, p = 0.019), peripheral blood flow (220 ± 166% vs. 130 ± 77%, p = 0.037), and velocity (164 ± 58% vs. 117 ± 45%, p = 0.011). Conclusion: Axillary plexus block produces an improvement of peripheral tissue oxygen saturation of the upper extremities over the first 6 h after the inception of anesthesia. This suggests a potential benefit especially for critically perfused tissues.

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“…The device used in our study quantifies the blood flow and the relative amount of hemoglobin. Performed measurements represent mainly the capillary‐venous compartment, because most of the hemoglobin is located in the capillary and postcapillary system of the microvascular bed . The measurements represent only the nutritive, microvascular vessels, because the light is completely absorbed if the vessel diameter is greater than 100 mm .…”

Section: Discussionmentioning

confidence: 99%

Determining the appropriate number and duration of leech therapy in congested tissues using tissue spectrophotometry and laser Doppler flowmetry

Rothenberger

Petersen²,

Schaller³

et al. 2016

Wound Repair Regeneration

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A universal protocol determining the number of leeches and their application time does not exist. The aim of this study, therefore, is to quantify perfusion dynamics in venous congested tissues after leech application to get more detailed information about changes due to leech-induced skin microcirculation and to evaluate the usability of the Oxygen to See (O2C) device in terms of determining the appropriate number of leeches and the duration of therapy. Twelve patients with the need for leech therapy participated in the study. Perfusion dynamics of the congested tissue was assessed using the O2C device, which determines blood flow (BF), the relative amount of hemoglobin (rHB), and the oxygen saturation (SO2). Measurements were carried out before leech application and on various intervals like 10 minutes, one hour, and three hours after leech application. The leech application effectuated after 10 minutes a nonsignificant perfusion improvement, which further increased after one hour with a significant reduction of the relative amount of hemoglobin and a significant increase of blood flow and oxygen saturation (BF= +56.7%; rHB= -25.5%; SO2= +53.7%). After three hours, the values returned to the levels before leech administration. In two cases, in which further administration of leeches within the measurement period was necessary, no substantial perfusion changes were obtained. The results of this study forms a more precise pattern of microcirculatory changes of leech therapy in congested tissues. According to our measurements a venous drainage improvement can be expected in congested tissue one hour after leech administration. The O2C seems to be a useful method to determine the appropriate number and duration of leech therapy.

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A quantitative analysis of microcirculation in sore-prone pressure areas on conventional and pressure relief hospital mattresses using laser Doppler flowmetry and tissue spectrophotometry

Cited by 19 publications

References 21 publications

Microclimate is an independent risk factor for the development of intraoperatively acquired pressure ulcers in the park‐bench position: A prospective observational study

Microclimate is an independent risk factor for the development of intraoperatively acquired pressure ulcers in the park‐bench position: A prospective observational study

Skin Perfusion Changes within 12 h after Axillary Plexus Block

Determining the appropriate number and duration of leech therapy in congested tissues using tissue spectrophotometry and laser Doppler flowmetry

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