title: Adaptive skin blood flow increases during hip-down lying in elderly women.
abstract: OBJECTIVE
  Pressure ulcer development due to unrelieved pressure during extended cardiovascular, orthopedic, and other procedures is an important clinical problem. Because blood flow changes within pressure-loaded tissue affect the skin breakdown process, the relative effects of 2 support surface strategies on trochanter skin blood flow were investigated.
  
  
  METHODS
  Skin blood perfusion was assessed by laser Doppler methods during 1 hour of continuous loading. Blood perfusion was measured before and during hip-down loading on a gel pad (static surface) and a dynamic multisegmental surface that provided periodic alternating pressure relief. Female volunteers (N = 20, age > or = 60 years) were tested on each surface in random order with sequential tests separated by 5 to 8 days. Effects were assessed by comparing perfusion during the first and last 15 minutes of hip-down loading with a 15-minute baseline.
  
  
  METHODS
  Research center.
  
  
  RESULTS
  Pre-load perfusions (dynamic vs static support) were similar (0.57 +/- 0.06 vs 0.64 +/- 0.08). During loading, however, a significant progressive increase in perfusion was noted only with dynamic support; by the end of the loading interval, this increase in perfusion had significantly exceeded the pre-load baseline (1.22 +/- 0.26, P = 0.001).
  
  
  CONCLUSIONS
  These findings reveal a surface-dependent blood flow impact, with the multisegmental dynamic approach being associated with greater flow during loading. The mechanism, though speculative, is consistent with a greater vascular adaptation potential offered by the dynamic surface. Conditions that facilitate such adaptive flow increases would appear to be of considerable benefit in helping to prevent ulcer development.
authors.affiliation: College of Medical Sciences, Nova Southeastern University, Fort Lauderdale, FL.
authors.forename: H N
authors.initials: HN
authors.lastname: Mayrovitz
authors.forename: J R
authors.initials: JR
authors.lastname: Smith
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001513:Beds / Q000592:standards*; D005260:Female; D006615:Hip; D006706:Homeostasis; D006801:Humans; D017078:Laser-Doppler Flowmetry; D008875:Middle Aged; D011187:Posture; D003668:Pressure Ulcer / Q000503:physiopathology* / Q000517:prevention & control*; D012039:Regional Blood Flow; D012867:Skin / Q000098:blood supply*