Document Detail

Skin perfusion responses to surface pressure-induced ischemia: implication for the developing pressure ulcer.
MedLine Citation:
PMID:  10661527     Owner:  NLM     Status:  MEDLINE    
This study describes alterations in skin perfusion in response to step increases in surface pressure, before and after long-term (5 hr) exposure to pressure-induced ischemia. A provocative test was developed in which surface pressure was increased in increments of 3.7 mmHg until perfusion reached an apparent minimum by a computer-controlled plunger that included a force cell, a laser Doppler flowmeter to determine perfusion, and a thermistor to monitor skin temperature. Force was applied to the greater trochanters of adult male fuzzy rats. Skin perfusion (n=7) initially increased with low levels of surface pressure (up to 13.9+/-1.9 mmHg) and then decreased with further increases in pressure, reaching minimum (zero) perfusion at 58.2+/-3.64 mmHg. After pressure release, reactive hyperemia (3 x normal) was observed, with levels returning to normal within 15-30 min. The provocative test was then applied after a 5-hr ischemic episode (produced by 92 mmHg) and 3 hr of recovery. A comparison of responses between stressed and unstressed skin revealed: elevated (63%) control perfusion levels; loss of the initial increase in perfusion with low levels of increasing pressure; a depression (45%) in the hyperemic response with delayed recovery time; and a decrease (54%) in amplitude of low frequency (<1 Hz) rhythms in skin perfusion. Skin surface temperature gradually increased both during the control period and the period of incremental increases in surface pressure (total DT=3.3 degrees C). The results suggest a compromised vasodilator mechanism(s). The provocative test developed in this study may have clinical potential for assessing tissue viability in early pressure ulcer development.
E C Herrman; C F Knapp; J C Donofrio; R Salcido
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Journal of rehabilitation research and development     Volume:  36     ISSN:  0748-7711     ISO Abbreviation:  J Rehabil Res Dev     Publication Date:  1999 Apr 
Date Detail:
Created Date:  2000-02-18     Completed Date:  2000-02-18     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8410047     Medline TA:  J Rehabil Res Dev     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  109-20     Citation Subset:  IM    
Center for Biomedical Engineering and the Department of Physical Medicine and Rehabilitation, University of Kentucky, Lexington 40536-0284, USA.
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MeSH Terms
Cell Survival
Ischemia / physiopathology*
Pressure Ulcer / physiopathology*
Regional Blood Flow
Skin / blood supply*
Vasodilation / physiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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