Clinical evaluation of the Skin IQ™ Microclimate Manager and case reports
Despite decades of scientific and clinical interest in pressure ulcers, much remains unclear regarding their development.
The primary role of high and/or prolonged mechanical loading on skin and soft tissue in pressure ulcer formation is widely accepted, and ameliorating the impact of mechanical loading (pressure and shear) has formed the cornerstone of pressure ulcer prevention1. However, a complex array of extrinsic and intrinsic factors interact to improve or reduce the ability of the skin and underlying soft tissues to withstand mechanical loading. Potentially, one of the central factors acting both extrinsically and intrinsically is the microclimate at the interface between the skin and the supporting bed or chair. Microclimate is associated with two parameters - temperature (of the skin or the soft tissues) and humidity or skin surface moisture at the interface between the skin and support surface2.
Excessive skin moisture and high relative humidity both weaken the skin and increase the friction coefficient, thus making the potential for pressure, shear and friction damage far greater. Higher skin temperatures raise the metabolic demands of local tissues, increasing the tissue's requirement for oxygen and susceptibility to the ischaemic effects of pressure and shear, and thus may be related to pressure ulceration3.
Some support surfaces can influence the local microclimate through the movement of air over the patient's skin, or by mechanically moving the surface of the support away from the skin. The primary function of these devices is pressure redistribution, not microclimate control. However, a new device is now available that, when used in combination with a pressure-redistributing mattress, can provide control of the skin microclimate, including skin surface cooling, prevention of excessive moisture and reduced friction.
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