title: Laser-Doppler imaging assessment of skin hyperemia as an indicator of trauma after adhesive strip removal.
abstract: The effect of adhesive tape and dressing removal on skin integrity is particularly important for patients who have increased risk for skin damage or impaired physiological responses to skin trauma. Visual observation of skin erythema does not always provide an adequate assessment of acute injury; detection of trauma is limited by the naturally occurring wide range of skin color and tones. This study had two purposes: (1) to assess the sensitivity and objectivity of laser-Doppler perfusion imaging (LDI) in measuring skin blood perfusion in forearm skin before and after removal of adhesive strips and (2) to determine the relationship between skin perfusion levels after adhesive-strip removal and the peel force required to remove the strips. Variations in peel-force levels were obtained in two ways: first, from naturally occurring skin differences; and second, by using an adhesive remover product (ARP) developed to reduce skin trauma. In 10 subjects, acrylic adhesive strips (13 x 70 mm) were placed in pairs on standardized sites on both volar forearms and peeled off 24 hours later at a constant velocity of 5 mm/sec while the peel force was recorded. During peeling, an ARP was used with one strip; nothing was used on the adjacent paired strip (CONTROL). Skin blood perfusion was measured at 5 and 20 minutes after strip removal by non-contact LDI under the ARP and CONTROL conditions simultaneously. Results show that (1) hyperemia after strip removal is linearly related to peel force (r2 = 0.55, p < .01): (2) use of an ARP, as indexed by the hyperemic response, significantly reduces skin trauma (1.02 [SD = 0.11] versus 1.47 [SD = 0.11], p < .01) with a mean CONTROL/ARP ratio of 1.56; and (3) the peel force required is reduced by using an ARP. These findings indicate that LDI is a useful, sensitive tool for assessment of skin trauma and that reducing peel forces has a positive effect.
authors.affiliation: Bioscience Research Institute, Sunrise, Fla, USA.
authors.forename: H N
authors.initials: HN
authors.lastname: Mayrovitz
authors.forename: S G
authors.initials: SG
authors.lastname: Carta
mesh_terms: D000269:Adhesives / Q000009:adverse effects*; D000328:Adult; D001696:Biomechanical Phenomena; D005260:Female; D005542:Forearm; D006801:Humans; D006940:Hyperemia / Q000000981:diagnostic imaging* / Q000209:etiology; D017078:Laser-Doppler Flowmetry / Q000592:standards; D008297:Male; D008875:Middle Aged; D009730:Nursing Assessment; D012680:Sensitivity and Specificity; D012867:Skin / Q000098:blood supply* / Q000293:injuries*; D014463:Ultrasonography
chemical_list: D000269:Adhesives