The influence of incontinence pads moisture at the loaded skin interface

The identification of biophysical parameters which reflect skin status following mechanical and chemical insults

“…Interestingly, there were no differences in the biophysical parameters with age, consistent with previous studies conducted at the host laboratory (Bostan et al, 2019;Woodhouse et al, 2015). Further studies incorporating the measurement of local skin thickness would enable effects of BMI to be fully evaluated.…”

“…In the present study, with TEWL measured at discrete time points, a similar transient response was evident when skin was exposed to a pad saturated with water (Figure 2a). Sustained mechanical loading, a widely recognized risk factor for PUs, has been reported to result in both a temporary loss of skin barrier function and erythema (Bostan et al, 2019;Kottner et al, 2015). In particular, a recent study by the authors reported a small (~3 g m −2 h −1 ), but significant increase in TEWL values at the sacrum following applied pressures of 9 kPa (Bostan et al, 2019).…”

“…Sustained mechanical loading, a widely recognized risk factor for PUs, has been reported to result in both a temporary loss of skin barrier function and erythema (Bostan et al, 2019;Kottner et al, 2015). In particular, a recent study by the authors reported a small (~3 g m −2 h −1 ), but significant increase in TEWL values at the sacrum following applied pressures of 9 kPa (Bostan et al, 2019). Based on the selected threshold, that is 8 g m −2 h −1 , the present findings, however, demonstrate no changes in the skin barrier response for the majority of the participants (9/11).…”

“…Four separate insults were imposed on the test sites to simulate real-life conditions, while two sites were used as negative controls (Figure 1). Tape stripping (n = 40), which represents a minimally invasive method that removes the skin layers, was used as a positive control as in previous studies (Bostan et al, 2019;Koppes et al, 2016;Koudounas, 2019). Chemically induced irritation was simulated by applying a surfactant, sodium lauryl sulphate (SLS) at 0.5% concentration, to the skin surface.…”

“…These include non-invasive methods to monitor the barrier function, pH, elasticity, blood flow, structural changes and colour of the skin (Worsley & Voegeli, 2013). For example, an increase in transepidermal water loss (TEWL), indicative of altered skin barrier function, has been observed in a number of skin conditions, such as atopic dermatitis and in experimental perturbation studies, wherein skin is subjected to repetitive mechanical loading or application of solvents (Bostan et al, 2019;de Jongh et al, 2006). Another biophysical measure that has gained recent attention is sub-epidermal moisture (SEM) that estimates electrical capacitance as a means to evaluate local oedema in the epidermal/sub-epidermal tissues (Gefen & Ross, 2020;Mayrovitz et al, 2009).…”