title: Biophysical skin properties of grade 1 pressure ulcers and unaffected skin in spinal cord injured and able-bodied persons in the unloaded sacral region.
abstract: OBJECTIVE
  To examine biophysical skin properties in the sacral region in spinal cord injury (SCI) patients suffering from a grade 1 pressure ulcer (PU) defined as non-blanchable erythema (SCI/PU), SCI patients in the post-acute phase (SCI/PA) and able-bodied participants (CON). Also, for SCI/PU patients, both the affected skin and healthy skin close to the PU were examined.
  
  
  METHODS
  An experimental controlled study with a convenience sample.
  
  
  METHODS
  A Swiss acute care and rehabilitation clinic specializing in SCIs.
  
  
  METHODS
  We determined hydration, redness, elasticity and perfusion of the unloaded skin in the sacral region of 6 SCI/PU patients (affected and healthy skin), 20 SCI/PA patients and 10 able-bodied controls. These measures were made by two trained examiners after the patients were lying in the supine position.
  
  
  RESULTS
  The affected skin of SCI/PU patients showed elevated redness: median 595.5 arbitrary units (AU) (quartiles 440.4; 631.6) and perfusion: 263.0 AU (104.1; 659.4), both significantly increased compared to the healthy skin in SCI/PA patients and CON (p < 0.001). Similarly, healthy skin of SCI/PA patients showed elevated redness (p = 0.016) and perfusion (p < 0.001) compared to CON. On the other hand, differences in redness and perfusion between the affected and unaffected skin in SCI/PU patients were not significant. The results for skin hydration and skin elasticity were similar in all groups.
  
  
  CONCLUSIONS
  Skin perfusion and redness were significantly increased in grade 1 PUs and for healthy skin in both SCI/PA patients and CON participants; thus, these are important in understanding the pathophysiology of PUs and skin in SCI.
authors.affiliation: Swiss Paraplegic Center, Nottwil, Switzerland. Electronic address: anke.scheel@paraplegie.ch.
authors.forename: Anke
authors.initials: A
authors.lastname: Scheel-Sailer
authors.affiliation: Swiss Paraplegic Center, Nottwil, Switzerland.
authors.forename: Angela
authors.initials: A
authors.lastname: Frotzler
authors.affiliation: Swiss Paraplegic Center, Nottwil, Switzerland.
authors.forename: Gabi
authors.initials: G
authors.lastname: Mueller
authors.affiliation: Empa, Swiss Federal Laboratories for Materials Science and Technology, Laboratory for Protection and Physiology, St. Gallen, Switzerland.
authors.forename: Simon
authors.initials: S
authors.lastname: Annaheim
authors.affiliation: Empa, Swiss Federal Laboratories for Materials Science and Technology, Laboratory for Protection and Physiology, St. Gallen, Switzerland.
authors.forename: René Michel
authors.initials: RM
authors.lastname: Rossi
authors.affiliation: Empa, Swiss Federal Laboratories for Materials Science and Technology, Laboratory for Protection and Physiology, St. Gallen, Switzerland.
authors.forename: Siegfried
authors.initials: S
authors.lastname: Derler
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D065228:Non-Randomized Controlled Trials as Topic; D003668:Pressure Ulcer / Q000145:classification / Q000209:etiology / Q000503:physiopathology*; D012445:Sacrococcygeal Region; D012447:Sacrum; D012867:Skin / Q000098:blood supply / Q000473:pathology; D012879:Skin Physiological Phenomena; D013119:Spinal Cord Injuries / Q000150:complications*
keywords: Skin elasticity; Skin hydration; Skin perfusion; Skin physiology; Skin redness