Abstract
Background: Previous studies have not specifically measured skin characteristics at common sites of pressure ulcers in high-risk elderly patients. Therefore, this study aimed to clarify the physiological skin characteristics at common pressure ulcer sites and their relationship with pressure ulcer risk and demographic/laboratory data in bedridden elderly Japanese patients. Methods: This study involved 55 elderly Japanese patients in a long-term care hospital and 25 female Japanese university students. Skin surface temperature, epidermal water content, transepidermal water loss, skin erythema/redness, skin elasticity, and skin thickness were measured using noninvasive devices. The sacral and both heel areas (sites predisposed to pressure ulcers) and mid-to-lower back area (control site) were observed. Results: Elderly patients showed a low epidermal water content at both heels (right heel, 14.8 ± 9.1 arbitrary units, AU.; left heel, 14.4 ± 8.3 AU). Transepidermal water loss remained acceptable at all sites in older patients despite the presence of dry skin (back, 7.1 ± 1.8 g/hm2; sacrum, 7.4 ± 3.0 g/hm2; right heel, 17.7 ± 7.1 g/hm2; left heel, 19.4 ± 8.1 g/hm2). Back (0.61 ± 0.13 AU) and sacral (0.67 ± 0.11 AU) skin elasticity and sacral skin thickness (0.97 ± 0.56 cm) were significantly lower than those of healthy young people (0.86 ± 0.04 AU, 0.87 ± 0.05 AU, and 2.27 ± 0.84 cm, respectively; p p p < 0.001) in older patients. Conclusions: Our findings showed that skin thickness and elasticity should be prioritized when evaluating pressure ulcer risk at the sacral region in bedridden elderly Japanese patients. Moreover, skin moisturization should be considered to minimize the risk at the heels in such patients.
Highlights
As suggested by VanGilder et al [1], prevalence rates of pressure ulcers across all facilities within the United States have decreased from 13.5% in 2006 to 9.3% in 2015
Our findings showed that skin thickness and elasticity should be prioritized when evaluating pressure ulcer risk at the sacral region in bedridden elderly Japanese patients
Regarding the presence of pressure ulcer risk factors in elderly patients, 38 were unable to reposition themselves in bed (69.1%), 50 had urinary incontinence (90.9%), and 43 had fecal incontinence (78.2%)
Summary
As suggested by VanGilder et al [1], prevalence rates of pressure ulcers across all facilities within the United States have decreased from 13.5% in 2006 to 9.3% in 2015. Previous studies have not measured skin characteristics at common sites of pressure ulcers in high-risk elderly patients. Epidermal water content, transepidermal water loss, skin erythema/redness, skin elasticity, and skin thickness were measured using noninvasive devices. The sacral and both heel areas (sites predisposed to pressure ulcers) and mid-to-lower back area (control site) were observed. Transepidermal water loss remained acceptable at all sites in older patients despite the presence of dry skin (back, 7.1 ± 1.8 g/hm; sacrum, 7.4 ± 3.0 g/hm; right heel, 17.7 ± 7.1 g/hm; left heel, 19.4 ± 8.1 g/hm). Conclusions: Our findings showed that skin thickness and elasticity should be prioritized when evaluating pressure ulcer risk at the sacral region in bedridden elderly Japanese patients. Skin moisturization should be considered to minimize the risk at the heels in such patients
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