Superficial skin damage and pressure sores due to skin loading A Literature Review

Pressure sores are localized areas of tissue breakdown in skin and/or underlying tissue. They are painful, difficult to treat, and represent a burden to the community in terms of health care and money. Massive efforts to prevent pressure sores have not resulted in a reduction of the prevalence. This is at least partly due to a lack of understanding of the etiology of pressure sores. The goal of this joint project by Eindhoven University of Technology and Philips Personal Care Institute is to investigate non-invasively and in vivo, the initiation of (superficial) pressure sores in the skin. It is assumed that the initiation of these pressure sores coincides with the irritation of the skin caused by shaving. This means that the future results of the project also can be used in the field of shaving. The literature review describes the available knowledge on the structure and function of the skin, experiments that studied skin irritation and skin loading, and research involving skin imaging and spectroscopy. The open research fields in skin irritation and loading consists of:-Structural skin analysis after loading and irritation by imaging techniques, especially by confocal laser scanning microscopy.-The application of functional measurement techniques used in skin irritation research to study the effect of skin loading (with shear, friction).-Quantitative measurements of ion en cytokine concentrations after skin loading. This leads to a proposal of the following experimental study: Frictional forces will be applied to the human skin in vivo, using a load applicator. This device should be able to rub the skin for selected durations and with variable velocities, using a minimal normal force. The normal force of the load applicator on the skin surface should be minimal to be able to study the effect of only frictional forces on the skin. When normal forces are too large, they cause occlusion of the skin capillaries, which should be prevented. That's why skin microcircula-tion will be monitored by reflectance spectroscopy. The skin response to the frictional forces will be measured by techniques that are able to detect functional changes in the skin after irritation. These techniques include measurements of TEWL, skin erythema, and skin capacitance. Confocal laser scanning microscopy will be used to measure possible structural changes (skin layer thickness, cell size) in the skin after rubbing it.-Irritation, expressed by TEWL, skin erythema and capacitance will be studied as a function of applied load, duration of load application and …