title: Understanding the Acute Skin Injury Mechanism Caused by Player-Surface Contact During Soccer: A Survey and Systematic Review.
abstract: BACKGROUND
  Superficial skin injuries are considered minor, and their incidence is probably underestimated. Insight into the incidence and mechanism of acute skin injury can be helpful in developing suitable preventive measures and safer playing surfaces for soccer and other field sports.
  
  
  OBJECTIVE
  To gain insight into the incidence and severity of skin injuries related to soccer and to describe the skin injury mechanism due to player-surface contact.
  
  
  METHODS
  Systematic review; Level of evidence, 4.
  
  
  METHODS
  The prevention model by van Mechelen et al (1992) combined with the injury causation model of Bahr and Krosshaug (2005) were used as a framework for the survey to describe the skin injury incidence and mechanism caused by player-surface contact.
  
  
  RESULTS
  The reviewed literature showed that common injury reporting methods are mainly based on time lost from participation or the need for medical attention. Because skin abrasions seldom lead to absence or medical attention, they are often not reported. When reported, the incidence of abrasion/laceration injuries varies from 0.8 to 6.1 injuries per 1000 player-hours. Wound assessment techniques such as the Skin Damage Area and Severity Index can be a valuable tool to obtain a more accurate estimation of the incidence and severity of acute skin injuries.
  
  
  CONCLUSIONS
  The use of protective equipment, a skin lubricant, or wet surface conditions has a positive effect on preventing abrasion-type injuries from artificial turf surfaces. The literature also shows that essential biomechanical information of the sliding event is lacking, such as how energy is transferred to the area of contact. From a clinical and histological perspective, there are strong indications that a sliding-induced skin lesion is caused by mechanical rather than thermal injury to the skin.
authors.affiliation: ConsumersVoice, Sint Nicolaasga, the Netherlands.
authors.forename: Wilbert A J
authors.initials: WA
authors.lastname: van den Eijnde
authors.affiliation: Department of Dermatology, Radboud University Medical Center, Nijmegen, the Netherlands.
authors.forename: Malou
authors.initials: M
authors.lastname: Peppelman
authors.affiliation: Reden BV, Hengelo, the Netherlands.
authors.forename: Edwin A D
authors.initials: EA
authors.lastname: Lamers
authors.affiliation: Department of Dermatology, Radboud University Medical Center, Nijmegen, the Netherlands.
authors.forename: Peter C M
authors.initials: PC
authors.lastname: van de Kerkhof
authors.affiliation: Department of Dermatology, Radboud University Medical Center, Nijmegen, the Netherlands.
authors.forename: Piet E J
authors.initials: PE
authors.lastname: van Erp
keywords: artificial turf; injury mechanism; review; skin injury; soccer