title: A new method to evaluate the effects of shear on the skin.
abstract: Currently, pressure ulcer preventive strategies focus mainly on pressure redistribution. Little attention is paid to reduce the harmful effects of shear-force, because little is known about pathophysiological aspects of shear-force. Even today, no method to measure the effects of shear-force on the skin is available. Therefore, the aim of this study was to investigate the response to shear-forces in terms of analyzing a noninvasive biomarker and reactive hyperemic parameter measured at the skin of healthy participants. A physical model was developed to produce a combination of pressure and shear or pressure alone on the skin. Ten healthy male participants were included and pressure (3.9 kPa) and a combined loading of pressure and shear (2.4 kPa + 14.5 N) was applied at the volar aspect of the forearms for 15 and 30 minutes. A Sebutape sample was used to collect IL-1α and total protein (TP) noninvasively. The reactive hyperemic parameter was derived from a laser Doppler flowmeter. The increase in IL-1α/TP-ratio after a combined loading of pressure and shear for 30 minutes of 6.2 ± 2.5 was significantly higher compared with all other test conditions (p < 0.05). The increase in cutaneous blood cell flux was already significantly higher when a combined loading of pressure and shear was applied for 15 minutes compared with pressure alone. These results shows that the IL-1α/TP-ratio and cutaneous blood cell flux can be used as robust measures of the effect of shear-force on skin in humans. Therefore, this model can be used to evaluate materials aimed at the reduction of shear.
authors.affiliation: Department of General Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.|NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands.
authors.forename: Luuk A
authors.initials: LA
authors.lastname: de Wert
authors.affiliation: Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands.|Faculty of Health Sciences, Clinical Academic Facility, University of Southampton, Southampton, United Kingdom.
authors.forename: Dan L
authors.initials: DL
authors.lastname: Bader
authors.affiliation: Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands.
authors.forename: Cees W J
authors.initials: CW
authors.lastname: Oomens
authors.affiliation: Faculty of Health Sciences, Clinical Academic Facility, University of Southampton, Southampton, United Kingdom.|Scientific Institute for Quality of Healthcare, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Lisette
authors.initials: L
authors.lastname: Schoonhoven
authors.affiliation: Department of General Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.|NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands.
authors.forename: Martijn
authors.initials: M
authors.lastname: Poeze
authors.affiliation: Department of General Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.|NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands.
authors.forename: Nicole D
authors.initials: ND
authors.lastname: Bouvy
mesh_terms: D000328:Adult; D064368:Healthy Volunteers; D006801:Humans; D006940:Hyperemia / Q000503:physiopathology*; D017078:Laser-Doppler Flowmetry; D008297:Male; D011312:Pressure; D003668:Pressure Ulcer / Q000503:physiopathology; D033081:Shear Strength / Q000502:physiology*; D012867:Skin / Q000503:physiopathology*; D012881:Skin Temperature; D013314:Stress, Mechanical; D014945:Wound Healing / Q000502:physiology