Challenges to measure hydration, redness, elasticity and perfusion in the unloaded sacral region of healthy persons after supine position

Physicochemical and Sensory Evaluation of Sustainable Plant-Based Homopolymers as an Alternative to Traditional Emollients in Topical Emulsions

Objectives: This study evaluated the potential of sustainably sourced, plant-based homopolymers derived from citronellol as an alternative to the traditional emollients used in pharmaceutical, cosmetic, and personal care products. With increasing emphasis on environmentally friendly ingredients and manufacturing processes, this study assessed the efficacy of these homopolymers in semi-solid and emulsion-based formulations. Methods: The analyses focused on physicochemical, sensory, biophysical, and neurosensory characteristics. Results: The results demonstrated that emulsions containing sustainable homopolymers maintained viscoelastic stability, preserving rheological properties over time under varying conditions. These formulations showed comparable structural and functional stability to those with traditional emollients while offering skin hydration, moisture retention, and elasticity, with reduced transepidermal water loss. Sensory evaluations highlighted positive user acceptance, with participants favoring the skin feel and in-use qualities of these emulsions over synthetic alternatives. Neurosensory analyses confirmed the strong visual appeal of the product packaging, capturing user attention effectively. Conclusions: These findings underline the capability of plant-based homopolymers to replace traditional emollients while providing significant consumer appeal and sustainability benefits. This study establishes their potential as viable components in the development of more eco-friendly topical formulations for the pharmaceutical, cosmetic, and personal care industries.

Tissue temperature, flux and oxygen of sacral and trochanteric area under pressure of healthy subjects: A quasi-experimental study

AIM

To evaluate the changes that take place in the perfusion, oxygenation and local temperature of the skin of the sacrum and trochanter when subjected to direct pressure for 2 h.

METHODS

Quasi-experimental study in the preclinical phase with healthy subjects acting as their own controls (intrasubject control). The outcome variables were measured with a laser Doppler system (local temperature and oxygenation) and by near-infrared spectroscopy (perfusion). The pressure exerted was measured with a capacitive pressure sensor. No more than one week elapsed between the sacrum and trochanter measurements.

RESULTS

The study sample consisted of 18 persons. The comparative analysis of the fluctuations in the parameters measured on the skin of the trochanters and sacrum, according to the time elapsed, revealed a statistically significant increase in temperature and in the pressure exerted. On the other hand, the changes in capillary blood flow and in SaO2 were not statistically significant.

CONCLUSION

Our study results show that changes found in terms of temperature and pressure should be taking into account when planning personalised repositioning to patients according to biomechanical and biological situations that vary between anatomical areas. In future research, the changes reported could be evaluated in patients with risk factors for the development of pressure ulcers, thus facilitating the introduction of more personalised planning in the care and prevention of these injuries.

Changes in skin-physiology after local heat application using two different methods in individuals with complete paraplegia: a feasibility and safety trial

STUDY DESIGN

Interventional feasibility study.

OBJECTIVES

To evaluate safety and effects of local heat preconditioning on skin physiology using water-filtered infrared-A radiation (wIRA) or warm water therapy (wWT) in individuals with spinal cord injury (SCI).

SETTING

Acute and rehabilitation center, specialized in SCI.

METHODS

A convenience sample of 15 individuals (3 women, 12 men) with complete paraplegia from thoracic levels ranging between T2 and T12 received local heat applications either with wIRA or wWT on the thigh (paralyzed area) and on the upper arm (non-paralyzed area). Local heat was applied during three 30-min cycles, each separated by 30 min rest; thus, the treatment lasted for 180 min. Temperature, blood perfusion, and skin redness were measured at baseline, before and after heat application and 24 h after the last application.

RESULTS

Heat applications with wIRA and wWT were well-tolerated. No burns or any other side effects were detected. Skin temperature (p ≤ 0.008) and blood perfusion (p ≤ 0.013) significantly increased after heat application. Local skin temperature (arm p = 0.004/leg p < 0.001) and blood perfusion (arm p = 0.011/leg p = 0.001) after the first and the second application cycle, respectively, were significantly higher during heat application with wIRA than with wWT. However, skin redness did not change significantly (p = 0.1). No significant differences were observed between the paralyzed and non-paralyzed areas for all parameters immediately, as well as 24 h after the treatment.

CONCLUSIONS

Although both heating methods have been confirmed as safe treatments in this study, further investigations with regard to their efficacy in the context of preconditioning are warranted.

SPONSORSHIP

The use of the instruments Hydrosun® 750 Irradiator (Hydrosun Medizintechnik, Germany) and Hilotherm-Calido 6 (Hilotherm GmbH, Germany) was sponsored by the Dr. med. h. c. Erwin Braun Foundation and by Hilotherm GmbH, respectively.

The relationship between pressure offloading and ischial tissue health in individuals with spinal cord injury: An exploratory study

Objectives: To compare thickness and texture measures of tissue overlying the ischial region in able-bodied (AB) individuals vs. individuals with spinal cord injury (SCI) and to determine if there is a relationship between pressure offloading of the ischial tuberosities (IT) and tissue health in individuals with SCI. Design: Exploratory cross-sectional study. Setting: University setting and rehabilitation hospital. Outcome Measures: Thickness and texture measurements from ultrasound images of tissues overlying the IT were obtained from AB individuals (n = 10) and individuals with complete or incomplete traumatic and non-traumatic SCI American Spinal Injury Association Impairment Scale (AIS) classification A-D (n = 15). Pressure offloading was measured in individuals with SCI and correlated with tissue health measurements. Results: The area overlying the IT occupied by the muscle was significantly greater in the SCI when compared with AB cohort. The area occupied by the muscle in individuals with SCI appeared to lose the striated appearance and was more echogenic than nearby skin and subcutaneous tissue (ST). There was no correlation between offloading times and thickness, echogenicity and contrast measurements of skin, ST and muscle in individuals with SCI. Conclusion: Changes in soft tissues overlying the ischial tuberosity occur following SCI corresponding to the loss of striated appearance of muscle and increased thickness of the area occupied by the muscle. Further studies using a larger sample size are recommended to establish if thickness and tissue texture differ between individuals with SCI who sustain pressure injuries vs. those who do not.

Technologies to monitor the health of loaded skin tissues

There are many situations where the skin and underlying soft tissues are compromised by mechanical loading in the form or pressure, or pressure in combination with shear. If sustained, this can lead to damage in the tissues particularly adjacent to bony prominences, resulting in chronic wounds. An array of bioengineering technologies have been adopted to assess the integrity of loaded soft tissues. This paper aims to review these approaches for the quantification, simulation and early detection of mechanically-induced skin damage. The review considers different measurements at the interface between the skin and support surface/medical device, involving pressure, shear, friction and the local microclimate. The potential of the techniques to monitor the physiological response of the skin to these external stimuli including biophysical measurement devices and sampling of biofluids are critically analysed. In addition, it includes an analysis of medical imaging technologies and computational modelling to provide a means by which tissue deformation can be quantified and thresholds for tissue damage defined. Bioengineering measurement and imaging technologies have provided an insight into the temporal status of loaded skin. Despite the advances in technology, to date, the translation to clinical tools which are robust and cost effective has been limited. There is a need to adapt existing technologies and simulation platforms to enable patients, carers and clinicians to employ appropriate intervention strategies to minimise soft tissue damage.

Comparing the effects of 3 different pressure ulcer prevention support surfaces on the structure and function of heel and sacral skin: An exploratory cross-over trial

Special support surfaces are key in pressure ulcer prevention. The aim of this study was to measure the effects of 3 different types of mattresses (reactive gel, active alternating air, basic foam) on skin properties of the sacral and heel skin after 2 hours loading. Fifteen healthy females (median age 66 years) were included. Transepidermal water loss, skin surface temperature, erythema, stratum corneum hydration, epidermal hydration, skin extensibility, elastic function, and recovery as well as skin roughness parameters were measured under controlled room conditions before loading, immediately after loading, and 20 minutes post-loading in the supine position on the different mattresses. The highest increases in transepidermal water loss, skin temperature, and erythema were observed for the foam mattress after loading, indicating higher deformation and occlusion. Cutaneous stiffness decreased in all 3 groups, indicating structural changes during loading. There was a substantial decrease of mean roughness at the heel skin in the foam group, leading to a flattening of the skin surface. Study results indicate that the type of support surface influences skin structure and function during loading. The gel and air mattress appeared to be more protective compared with the foam mattress, but the differences between the gel and air were minor.