Abstract
BackgroundPerioperative skin injury is a major issue; therefore, several preventative measures have been developed. However, no previous studies have visualized the effects of stromal edema caused by surgical invasion of skin tissue, and therefore, the details remain unknown. We used an ultrasonic diagnostic imaging device to clarify changes in the skin tissue structure of patients after open surgery.Materials and MethodsTwenty subjects who underwent open hepatectomy were enrolled. We selected the lateral abdomen, upper arms, and lower legs as ultrasonic imaging measurement sites. We performed measurements on the day before surgery and on postoperative days 1, 3, and 5. We calculated the epidermal/dermal tissue thickness, subcutaneous tissue thickness, and skin tissue thickness. We performed a one‐way analysis of variance with repeated measurements for each of the postoperatively measured values on the basis of the preoperative values. Significantly different variables were subjected to the Bonferroni method. We evaluated ultrasonic imaging findings and skin injury.ResultsEpidermal/dermal tissue thickness at all measurement sites exhibited sustained thickening on postoperative day 5 compared to that preoperatively. The lateral abdomen exhibited thickening of the subcutaneous tissue and skin tissue on postoperative day 1. In addition, increased echogenicity, increased opacity of the layer structure, and a cobblestone appearance occurred during the postoperative course. Postoperatively, 80% of subjects exhibited skin injury.ConclusionWe evaluated the effects of surgical invasion on skin tissue over time. Continual observation and protective skincare are necessary near the surgical wound, where significant invasiveness occurs. Prevention of skin injury due to skin tissue thickening requires further study.
Highlights
Skin tissue, which is composed of the epidermis, dermis, and sub‐ cutaneous tissue, protects the body from various stimuli and from encroachment by water, microorganisms, and foreign substances
The amount of moisture movement into the interstitial fluid is greatest during upper abdominal surgery, such as open hepatectomy, which was the subject of this study in particular,[10] and increased bleeding results in larger amounts of fluid and blood transfusion, further leading to a collapse of the balance of body fluid circulation
We focused on evaluating the skin tissue structure using an ultrasonic diagnostic imaging device
Summary
Skin tissue, which is composed of the epidermis, dermis, and sub‐ cutaneous tissue, protects the body from various stimuli and from encroachment by water, microorganisms, and foreign substances It is the largest organ of the body, with the epider‐ mis and dermis alone comprising approximately 14% of body weight.[1,2]. We focused on evaluating the skin tissue structure using an ultrasonic diagnostic imaging device Such devices are widely used in the clinical field to observe in‐ ternal organs. They are effectively utilized for evaluating muscle mass in the legs,[11] lymphedema,[12] and even surface tissues and for diagnosing pressure ulcers.[13] The technique is noninvasive and allows real‐time evaluation, and its accuracy and utility have been proven
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