&lt;p&gt;Using Skin Bioengineering to Highlight How Weight and Diabetes Mellitus Modify the Skin in the Lower Limbs of Super-Obese Patients&lt;/p&gt;

Iacopi, Elisabetta; Riitano, Nicola; Dini, Valentina; Berta, Rossana; Pieruzzi, Letizia; Janowska, Agata; Anselmino, Marco; Piaggesi, Alberto; Romanelli, Marco

doi:10.2147/dmso.s229042

Cited by 4 publications

(7 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In particular, obesity can lead to changes in skin thickness, blood flow, and oxygen saturation. This affects the optical properties of skin in addition to the distance light has to travel to reach a target vessel or vessels [ 48 , 59 , 60 ]. The variation of BMI across individuals is thus a potential source of variation for PPG measurements.…”

Section: Individual Variations In the Human Populationmentioning

confidence: 99%

“…The variation of BMI across individuals is thus a potential source of variation for PPG measurements. While, to the authors’ knowledge, publications that experimentally and explicitly demonstrate the effect of obesity or BMI on the PPG waveform are limited, we will explore works which suggest that there would be a substantial effect [ 56 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 ].…”

Section: Individual Variations In the Human Populationmentioning

confidence: 99%

“…These correlations of PPG with body temperature should be noted among varying demographic groups. For example, Iacopi et al found the skin of the foot of obese patients to be about 7 degrees Celsius higher than the foot of nonobese patients, and thus caution should be noted if PPG is measured at the foot [ 60 ].…”

Section: Physiologymentioning

confidence: 99%

See 2 more Smart Citations

Sources of Inaccuracy in Photoplethysmography for Continuous Cardiovascular Monitoring

et al. 2021

View full text Add to dashboard Cite

Photoplethysmography (PPG) is a low-cost, noninvasive optical technique that uses change in light transmission with changes in blood volume within tissue to provide information for cardiovascular health and fitness. As remote health and wearable medical devices become more prevalent, PPG devices are being developed as part of wearable systems to monitor parameters such as heart rate (HR) that do not require complex analysis of the PPG waveform. However, complex analyses of the PPG waveform yield valuable clinical information, such as: blood pressure, respiratory information, sympathetic nervous system activity, and heart rate variability. Systems aiming to derive such complex parameters do not always account for realistic sources of noise, as testing is performed within controlled parameter spaces. A wearable monitoring tool to be used beyond fitness and heart rate must account for noise sources originating from individual patient variations (e.g., skin tone, obesity, age, and gender), physiology (e.g., respiration, venous pulsation, body site of measurement, and body temperature), and external perturbations of the device itself (e.g., motion artifact, ambient light, and applied pressure to the skin). Here, we present a comprehensive review of the literature that aims to summarize these noise sources for future PPG device development for use in health monitoring.

show abstract

Section: Individual Variations In the Human Populationmentioning

confidence: 99%

Section: Individual Variations In the Human Populationmentioning

confidence: 99%

See 1 more Smart Citation

Sources of Inaccuracy in Photoplethysmography for Continuous Cardiovascular Monitoring

et al. 2021

View full text Add to dashboard Cite

show abstract

“…In particular, while an increase of thickness seems to be attributable to diabetes and observable when compared with nondiabetic patients, no differences are probably associated to the presence of diabetic neuropathy, thus suggesting a major role of glycosylated protein or microvessels. 98,99 When analyzing plantar pads, in particular under metatarsal head, these are as expected strongly reduced in diabetic patients comparing with nondiabetics but, once again, no significant differences can be related to the presence or absence of peripheral neuropathy. 100 The most important information derived by US assessment of foot are, however, related to plantar fascia.…”

Section: Ultrasound In the Neuropathic Diabetic Footmentioning

confidence: 68%

Ultrasound in the Modern Management of the Diabetic Foot Syndrome: A Multipurpose Versatile Toolkit

Pieruzzi

Napoli

Goretti

et al. 2020

The International Journal of Lower Extremity Wounds

Self Cite

View full text Add to dashboard Cite

Ultrasound (US) is a noninvasive and versatile technology that in recent years found acceptance in almost all the medical specialties, with diagnostic and interventional applications. In the diabetic foot syndrome (DFS), US found specific indications mainly in the screening, quantification, and follow-up of the vascular component of the pathology, but also in the study of the deformities and structural modifications induced by neuropathy and in the diagnosis and surgical management of infections, especially those that induce anatomical changes, like abscesses and fasciitis. This review will summarize all these application of US, giving special attention to the vascular aspects, and on the predominant role that US gained in recent times to guide the indication to revascularization, on the new standardized approach to the study of the arterial tree of the limb and the foot, the so-called duplex ultrasound arterial mapping, which significantly increased the utilization of US to plan the revascularizations in this complex pathology. Outside the vascular fields, the diagnosis of neuropathy and infection and the intraoperative use of US in the surgical management of abscesses and fasciitis will be discussed, leaving the last part to the new and interesting applications of US in the management of DFU, a field that is still in evolution, offering new possibilities to the health care professionals involved in the management of these chronic wounds. The variety of applications both in diagnostic and operative fields makes US a rather versatile technology—a toolkit—that should have a special place among those at reach of the specialists of DFS care.

show abstract

“…Iacopi et al. 112 reported an increase in thickness of skin and subcutaneous tissues at the lower limbs of obese patients.…”

Section: Differences In the Primary Layers Of The Skin With Obesitymentioning

confidence: 98%

Skin optical properties in the obese and their relation to body mass index: a review

et al. 2022

View full text Add to dashboard Cite

. Significance: Obesity is a worldwide epidemic contributing directly to several cardiovascular risk factors including hypertension and type 2 diabetes. Wearable devices are becoming better at quantifying biomarkers relevant for the management of health and fitness. Unfortunately, both anecdotal evidence and recent studies indicate that some wearables have higher levels of error when utilized by populations with darker skin tones and high body mass index (BMI). There is an urgent need for a better evaluation of the limits of wearable health technologies when used by obese individuals. Aims: (1) To review the current know-how on changes due to obesity in the skin epidermis, dermis, and subcutis that could affect the skin optical properties; (2) for the green wavelength range, to evaluate the difference in absorption and scattering coefficients from the abdominal skin between individuals with and without elevated BMI. The changes include alterations in layer thickness and cell size, as well as significant differences in chromophores and scatterer content, e.g., water, hemoglobin, collagen, and lipids. Approach: We have summarized literature pertaining to changes in skin and its components in obesity and report the results of our search using articles published between years 1971 and 2020. A linear model was used to demonstrate the absorption and reduced scattering coefficient of the abdominal skin of individuals with and without elevated BMI in the green wavelength range (530 to 550 nm) that is typically found in most wearables. Results: The general trends indicate a decrease in absorption for both dermis and subcutis and an increase in reduced scattering for both epidermis and dermis. At 544-nm wavelength, a typical wavelength used for photoplethysmography (PPG), the absorption coefficient’s relative percentage difference between high and low BMI skin, was 49% in the subcutis, 19% in the dermis, and negligible in the epidermis, whereas the reduced scattering coefficient relative difference was 21%, 29%, and 165% respectively. Conclusions: These findings suggest that there could be significant errors in the output of optical devices used for monitoring health and fitness if changes due to obesity are not accounted for in their design.

show abstract

<p>Using Skin Bioengineering to Highlight How Weight and Diabetes Mellitus Modify the Skin in the Lower Limbs of Super-Obese Patients</p>

Cited by 4 publications

References 31 publications

Sources of Inaccuracy in Photoplethysmography for Continuous Cardiovascular Monitoring

Sources of Inaccuracy in Photoplethysmography for Continuous Cardiovascular Monitoring

Ultrasound in the Modern Management of the Diabetic Foot Syndrome: A Multipurpose Versatile Toolkit

Skin optical properties in the obese and their relation to body mass index: a review

Contact Info

Product

Resources

About