Journal of Tissue Viability
Volume 19, Issue 3 , Pages 86-97 , August 2010

Effects of local cooling on sacral skin perfusion response to pressure: Implications for pressure ulcer prevention

  • Yi-Ting Tzen

      Affiliations

    • Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA, USA
    • ,
  • David M. Brienza

      Affiliations

    • Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA, USA
    • Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
    • Corresponding Author InformationCorresponding author. Bakery Square Office Building, Suite 401, 6425 Penn Avenue, Pittsburgh, PA 15206, USA.
    • ,
  • Patricia Karg

      Affiliations

    • Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA, USA
    • ,
  • Patrick Loughlin

      Affiliations

    • Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA

References 

  1. Stover SL, Fine PR. Spinal cord injury: the facts and figures. Birmingham: The University of Alabama at Birmingham; 1986;
  2. Chen Y, DeVivo MJ, Jackson AB. Pressure ulcer prevalence in people with spinal cord injury: age-period-duration effects. Arch Phys Med Rehabil. 2005;86:1208–1213
  3. Byrne DW, Salzberg CA. Major risk factors for pressure ulcers in the spinal cord disabled: a literature review. Spinal Cord. 1996;34(255–263):
  4. Yarkony GM. Pressure ulcers: a review. Arch Phys Med Rehabil. 1994;75:908–917
  5. Kosiak M. Etiology of decubitus ulcers. Arch Phys Med Rehabil. 1961;42:19–29
  6. Daniel RK, Priest DL, Wheatley DC. Etiologic factors in pressure sores: an experimental model. Arch Phys Med Rehabil. 1981;62:492–498
  7. Dinsdale SM. Decubitus ulcers: role of pressure and friction in causation. Arch Phys Med Rehabil. 1974;55:147–152
  8. Fisher SV, Szymke TE, Aptem SY, Kosiak M. Wheelchair cushion effect on skin temperature. Arch Phys Med Rehabil. 1978;59:68–71
  9. Stewart SFC, Palmieri V, Cochran GVB. Wheelchair cushion effect on skin temperature, heat flux, and relative humidity. Arch Phys Med Rehabil. 1980;61:229–233
  10. Cochran GVB. Measurement of pressure and other environmental factors at the patient–cushion interface. New York: McGraw-Hill; 1985;
  11. Kokate JY, Leland KJ, Held AM, Hansen GL, Kveen GL, Johnson BA, et al. Temperature-modulated pressure ulcers: a porcine model. Arch Phys Med Rehabil. 1995;76:666–673
  12. Iaizzo PA, Kveen GL, Kokate JY, Leland KJ, Hansen GL, Sparrow EM. Prevention of pressure ulcers by focal cooling: histological assessment in a porcine model. Wounds. 1995;7(5):161–169
  13. Sterne GD, Titley OG, Christie JL. A qualitative histological assessment of various storage conditions on short term preservation of human split skin grafts. Br J Plast Surg. 2000;53(4):331–336
  14. Riess ML, Camara AKS, Kevin LG, An J, Stowe DF. Reduced reactive O2 species formation and preserved mitochondrial NADH and [Ca2+] levels during short-term 17°C ischemia in intact hearts. Cardiovasc Res. 2004;61(3):
  15. Seiyama A, Kosaka H, Maeda N, Shiga T. Effect of hypothermia on skeletal muscle metabolism in perfused rat hindlimb. Cryobiology. 1996;33:338–346
  16. Ruch RC, Patton HD. Energy metabolism. 19th ed.. Philadelphia: Saunders Pr; 1965;
  17. Schubert V, Fagrell B. Postocclusive reactive hyperemia and thermal response in the skin microcirculation of subjects with spinal cord injury. Scand J Rehabil Med. 1991;23:33–40
  18. Jan Y-K, Brienza DM. Technology for pressure ulcer prevention. Top Spinal Cord Inj Rehabil. 2006;11(4):30–41
  19. Herrman EC, Knapp CF, Donofrio JC, Salcido R. Skin perfusion responses to surface pressure-induced ischemia: implication for the developing pressure ulcer. J Rehabil Res Dev. 1999;36(2):109–120
  20. Togawa T, Tamura T, Öberg PÅ. Chemical measurement. Boca Raton, Florida: CRC Press LLC; 1997;
  21. Togawa T, Tamura T, Öberg PÅ. Flow measurement. Boca Raton, Florida: CRC Press LLC; 1997;
  22. Schubert V, Fagrell B. Evaluation of the dynamic cutaneous post-ischaemic hyperaemia and thermal response in elderly subjects and in an area at risk for pressure sores. Clin Physiol. 1991;11(2):169–182
  23. Noble M, Voegeli D, Clough GF. A comparison of cutaneous vascular responses to transient pressure loading in smokers and nonsmokers. J Rehabil Res Dev. 2003;40(3):283–288
  24. Bongard O, Bounameaux H. Clinical investigation of skin microcirculation. Dermatology. 1993;186(1):6–11
  25. Skrha J, Prazn M, Haas T, Kvasnicka J, Kalvodova B. Comparison of laser-Doppler flowmetry with biochemical indicators of endothelial dysfunction related to early microangiopathy in Type 1 diabetic patients. J Diabet Complications. 2001;15:234–240
  26. Stewart J, Kohen A, Brouder D, Rahim F, Adler S, Garrick R, et al. Noninvasive interrogation of microvasculature for signs of endothelial dysfunction in patients with chronic renal failure. Am J Physiol Heart Circ Physiol. 2004;287:H2687–H2696
  27. Cracowski J-L, Minson CT, Salvat-Melis M, Halliwill JR. Methodological issues in the assessment of skin microvascular endothelial function in humans. Trends Pharmacol Sci. 2006;27:503–508
  28. Wilkin JK. Cutaneous reactive hyperemia: viscoelasticity determines response. J Invest Dermatol. 1987;89:197–200
  29. Rossi M, Carpi A, Maria CD, Franzoni F, Galetta F, Santoro G. Post-ischemic peak flow and myogenic flowmotion component are independent variables for skin post-ischemic reactive hyperaemia in healthy subjects. Microvasc Res. 2007;74:9–14
  30. Hagisawa S, Ferguson-Pell M, Cardi M, Miller D. Assessment of skin blood content and oxygenation in spinal cord injured subjects during reactive hyperemia. J Rehabil Res Dev. 1994;31(1):1–14
  31. Yvonne-Tee GB, Rassol AHG, Halim AS, Rahman ARA. Reproducibility of different laser Doppler fluximetry parameters of postocclusive reactive hyperemia in human forearm skin. J Pharmacol Toxicol. 2005;52:286–292
  32. Matsubara J, Narumi J, Nagasue M, Sakamoto S, Yuasa K, Shimizu T. Postocclusive reactive hyperemia during vascular reconstruction. Int J Angiol. 1998;7:222–227
  33. Binggeli C, Spieker LE, Corti R, Sudano I, Stojanovic V, Hayoz D, et al. Statins enhance postischemic hyperemia in the skin circulation of hypercholeserolemic patients. J Am Coll Cardiol. 2003;42(1):71–77
  34. Ruano J, Lopez-Miranda J, Fuentes F, Moreno JA, Bellido C, Perez-Martinez P, et al. Phenolic content of virgin olive oil improves ischemic reactive hyperemia in hypercholesterolemic patients. J Am Coll Cardiol. 2005;46(10):1864–1868
  35. Bracic M, Stefanovska A. Wavelet-based analysis of human blood flow dynamics. Bull Math Biol. 1998;60:919–935
  36. Cohen L. The need for time-frequency analysis. Time-frequency analysis. Englewood Cliffs, NJ: Prentice-Hall, Inc.; 1995;p. 70–81
  37. Cohen L. The short-time Fourier transform. Time-frequency analysis. Englewood Cliffs, NJ: Prentice-Hall, Inc.; 1995;p. 93–112
  38. Otte JW, Merrick MA, Ingersoll CD, Cordova ML. Subcutaneous adipose tissue thickness alters cooling time during cryotherapy. Arch Phys Med Rehabil. 2002;83:1501–1505
  39. Harpenden skinfold caliper manual. West Sussex, UK: British Indicators; 1998;
  40. Assous S, Humeau A, Tartas M, Abraham P, L'Huillier J-P. S-Transform applied to laser Doppler flowmetry reactive hyperemia signals. IEEE T Bio-med Eng. 2006;53(6):1032–1037
  41. Carolan-Rees G, Tweddel AC, Naka KK, Griffith TM. Fractal dimensions of laser Doppler flowmetry time series. Med Eng Phys. 2002;24:71–76
  42. Sprigle S, LInden M, Riordan B. Characterizing reactive hyperemia via tissue reflectance spectroscopy in response to an ischemic load across gender, age, skin pigmentation and diabetes. Med Eng Phys. 2002;24(10):651–661
  43. Sae-Sia W, Wipke-Tevis DD, Williams DA. The effect of clinically relevant pressure duration on sacral skin blood flow and temperature in patients after acute spinal cord injury. Arch Phys Med Rehabil. 2007;88:1673–1680
  44. Olivecrona GK, Gotberg M, Harnek J, Van der Pals J, Erlinge D. Mild hypothermia reduces cardiac post-ischemia reactive hyperemia. BMC Cardiovasc Disord. 2007;7(5):
  45. Patel S, Knapp CF, Donofrio JC, Salcido R. Temperature effects on surface pressure-induced changes in rat skin perfusion: implications in pressure ulcer development. J Rehabil Res Dev. 1999;36(3):189–201
  46. Stockwell RG, Mansinha L, Lowe RP. Localization of the complex spectrum: the S transform. IEEE Trans Signal Process. 1996;44(4):998–1001
  47. Jan Y-K, Brienza DM, Geyer MJ, Karg PE. Wavelet-based spectrum analysis of sacral skin blood flow response to alternating pressure. Arch Phys Med Rehabil. 2008;89:137–145
  48. Shibasaki M, Wilson TE, Cui J, Crandall CG. Acetylcholine released from cholinergic nerves contributes to cutaneous vasodilation during heat stress. J Appl Physiol. 2002;93:1947–1951
  49. Geyer MJ, Jan Y-K, Brienza DM, Boninger ML. Using wavelet analysis to characterize the thermoregulatory mechanisms of sacral skin blood flow. J Rehabil Res Dev. 2004;41(6A):797–806
  50. Johnson JM, Yen TC, Zhao K, Kosiba WA. Sympathetic, sensory, and nonneuronal contributions to the cutaneous vasoconstrictor response to local cooling. Am J Physiol Heart Circ Physiol. 2005;288(4):1573–1579
  51. Yamazaki F, Sone R, Zhao K, Alvarez GE, Kosiba WA, Johnson JM. Rate dependency and role of nitric oxide in the vascular response to direct cooling in human skin. J Appl Physiol. 2006;100:42–50

PII: S0965-206X(09)00066-7

doi: 10.1016/j.jtv.2009.12.003

Journal of Tissue Viability
Volume 19, Issue 3 , Pages 86-97 , August 2010

Article Tools

* Image Usage & Resolution