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Skin Morphology and Its Mechanical Properties Associated with Loading

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Pressure Ulcer Research

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References

  1. Osborne S (1987) A quality circle investigation. Nurs Times Feb 18:73–76

    Google Scholar 

  2. Goode HF, Burns E, Walker BE (1992) Vitamin C depletion and pressure sores in elderly patients with femoral neck fracture. BMJ 305(17):925–927

    PubMed  CAS  Google Scholar 

  3. Exton-Smith AN, Sherwin RW (1961) The prevention of pressure sores: Significance of spontaneous bodily movements. Lancet II:1124–1126

    Article  Google Scholar 

  4. Defloor T (1999) The risk of pressure sores: A conceptual scheme. J Clin Nurs 8:206–216

    Article  PubMed  CAS  Google Scholar 

  5. Allman RM (1989) Pressure ulcers among the elderly. N Engl J Med 320(13):850–853

    PubMed  CAS  Google Scholar 

  6. Anderson TP, Andberg MM (1979) Psychosocial factors associated with pressure sores. Arch Phys Med Rehabil 60:341–346

    PubMed  CAS  Google Scholar 

  7. Krouskop TA (1983) A synthesis of the factors that contribute to pressure sore formation. Med Hypotheses 11(2):255–267

    Article  PubMed  CAS  Google Scholar 

  8. Schubert V, Fagrell B (1991) Evaluation of the dynamic cutaneous post-ischemic hyperemia and thermal responses in elderly subjects and in an area at risk for pressure sores. Clin Physiol 11:169–182

    Article  PubMed  CAS  Google Scholar 

  9. Hagisawa S, Ferguson-Pell M, Cardi M, Miller SD (1994) Assessment of skin blood content and oxygenation in spinal cord injured subjects during reactive hyperemia. J Rehabil Res Dev 31(1):1–14

    PubMed  CAS  Google Scholar 

  10. Bader DL (1990) The recovery characteristics of soft tissues following repeated loading. J Rehabil Res Dev 27:141–150

    Article  PubMed  CAS  Google Scholar 

  11. Bogie M, Nuseibeh I, Bader DL (1992) Transcutaneous gas tension in the sacrum during the acute phase of spinal injury. Proc Inst Mech Eng [H] 206(1):1–6

    CAS  Google Scholar 

  12. Holloway GA (1984) Physiological causes of skin breakdown, In National Symposium on the Care, Treatment and Prevention of Decubitus Ulcers. Conference Proceedings, Virginia, pp 13–16

    Google Scholar 

  13. Ferguson-Pell M, Hagisawa S (1988) Biochemical changes in sweat following prolonged ischemia. J Rehabil Res Dev 25(3):57–62

    PubMed  CAS  Google Scholar 

  14. Polliack AA, Taylor R, Bader DL (1991) Sweat analysis of soft tissue under load. Annual Report 18, Oxford Orthopaedic Engineering Centre, pp 19–24

    Google Scholar 

  15. Hyman WA, Argue RS (1977) Oxygen and lactc acid transport in skeetal muscle effect of reactive hyperemia. Ann Biomed Eng 5:260–272

    Article  PubMed  CAS  Google Scholar 

  16. McCord JM (1985) Oxygen-free radicals in postischemic tissue injury. N Engl J Med 312(3):159–163

    PubMed  CAS  Google Scholar 

  17. Gute DC, Ishida T, Yarimizu K, Korthuis RJ (1988) Inflammatory responses to ischemia and reperfusion in skeletal muscle. Mol Cell Biochem 179:169–187

    Article  Google Scholar 

  18. Cotran RS, Kumar V, Collins T (1999) Acute and chronic inflammation. In: Pathologic basis of disease, 6th edn. Saunders, Philadelphia, pp 50–88

    Google Scholar 

  19. Sundin BM, Hussein MA, Glasofer S, El-Falaky MH, Abdel-Aleem SM, Sachse RE, Klitzman B (2000) The role of allopurinol and deferoxamine in preventing pressure ulcers in pigs. Plast Reconstr Surg 105:1408–1421

    Article  PubMed  CAS  Google Scholar 

  20. Houwing R, Overgoor M, Kon M, Jansen G, Asbeck ACV, Haalboom JRE (2000) Pressure-induced skin lesions in pigs: reperfusion injury and the effects of vitamin E. J Wound Care 9(1):36–40

    PubMed  CAS  Google Scholar 

  21. Husain T (1953) An experimental study of some pressure effects on tissues with reference to the bed-sore problem. J Pathol Bacteriol 66:347–358

    Article  PubMed  CAS  Google Scholar 

  22. Kosiak M (1961) Etiology of decubitus ulcers. Arch Phys Med Rehabil 42:19–29

    PubMed  CAS  Google Scholar 

  23. Wilms-Kretschmer K, Majno G (1969) Ischemia of the skin. Am J Pathol 54(3):327–343

    Google Scholar 

  24. Nola GT, Vistnes LM (1980) Differential response of skin and muscle in the experimental production of pressure sores. Plast Reconstr Surg 66(5):728–733

    PubMed  CAS  Google Scholar 

  25. Groth KE (1942) Klinische Beobachtungen and Experimentelle Studien über die Entstehung des Decubitus. Acta Chir Scand 87[Suppl 76]:1–203

    Google Scholar 

  26. Kosiak M (1959) Etiology and pathology of ischemic ulcers. Arch Phys Med Rehabil 40:62–68

    PubMed  CAS  Google Scholar 

  27. Dinsdale SM (1973) Decubitus ulcers in swine: Light and electron microscopy study of pathogenesis. Arch Phys Med Rehabil 55:51–56, 74

    Google Scholar 

  28. Daniel RK, Priest LD, Wheatley DC (1981) Etiologic factors in pressure sores: An experimental model. Arch Phys Med Rehabil 62:492–498

    PubMed  CAS  Google Scholar 

  29. Reswick JB, Rogers JE (1976) Experience at Rancho Los Amigos Hospital with devices and techniques to prevent pressure sores. In: Kenedi RM, Cowden JM, Scales JT (eds) Bedsore biomechanics. University Park Press, London, pp 301–310

    Google Scholar 

  30. Rose EH, Vistnes LM, Ksander GA (1977) The panniculus carnosus in the domestic pig. Plast Reconstr Surg 59(1):94–97

    PubMed  CAS  Google Scholar 

  31. Le KM, Madsen BL, Barth PW, Ksander GA, Angell JB. Vistnes LM (1984) An in-depth look at pressure sores using monolithic silicon pressure sensors. Plast Reconstr Surg 74(6):745–754

    PubMed  CAS  Google Scholar 

  32. Dodd KT, Gross DR (1991) Three-dimensional tissue deformation in subcutaneous tissues overlying bony prominences may help to explain external load transfer to the interstitium J Biomechanics 24(1):11–19

    Article  CAS  Google Scholar 

  33. Sangeorzan BJ, Harrington RM, Wyss CD, Czerniecki JM, Matsen FA (1989) Circulatory and mechanical response of skin to loading. J Orthop Res 7:425–431

    Article  PubMed  CAS  Google Scholar 

  34. Todd BA, Thacker JG (1994) Three-dimensional computer model of the human buttocks, in vivo. J Rehabil Res Dev 31(2):111–119

    PubMed  CAS  Google Scholar 

  35. Hagisawa S, Shimada T, Arao H, Asada Y (2001) Morphological architecture and distribution of blood capillaries and elastic fibres in the human skin. J Tissue Viability 11(2):59–63

    PubMed  CAS  Google Scholar 

  36. Sanders JE, Goldstein BS, Leotta DF (1995) Skin response to mechanical stress: adaptation rather than breakdown — a review of the literature. J Rehabil Res Dev 32(3):214–226

    PubMed  CAS  Google Scholar 

  37. Pasyk KA, Thomas SV, Hassett CA, Cherry GW, Faller R (1989) Regional differences in capillary density of the normal human dermis. Plast Reconstr Surg 83(6):939–947

    PubMed  CAS  Google Scholar 

  38. Ryan TJ (1983) Cutaneous circulation, In: Goldsmith LA (ed) Biochemistry and physiology of the skin., Oxford University Press, New York, pp 828–831

    Google Scholar 

  39. Liu X, Zhang Y, Liao J (1998) Regional differences in density of children’s skin — an enzyme histochemical and stereological study, Zhonghua Zheng Xing Shao Wai Ke Za Zhi 14(6):448–451

    CAS  Google Scholar 

  40. Tsuchida Y (1987) Regional differences in the skin blood flflow at various sites of the body studied by Xenon 133. Plast Reconstr Surg 80(5):705–710

    PubMed  CAS  Google Scholar 

  41. Scelsi R, Scelsi L, Bocchi R, Lotta S (1995) Morphological changes in the skin microlymphatics in recently injured paraplegic patients with ilio-femoral venous thrombosis. Paraplegia 33:472–475

    PubMed  CAS  ISI  Google Scholar 

  42. Reddy NP (1990) Effects of mechanical stresses on lymph and interstitial fluid flows, In: Bader DL (ed) Pressure sores: clinical practice and scientific approach. Macmillan Scientific & Medical, London, pp 203–220

    Google Scholar 

  43. Shimada T, Morita T, Oya M.(1991) Structures and architectures of lymphatic capillaries: Morphological differences from blood capillaries. Jpn Soc Electron Microsc 26(1):66–71

    Google Scholar 

  44. Reddy NP, Patel K (1995) A mathematical model of flow through the terminal lymphatics. Med Eng Phys 17(2):134–140

    Article  PubMed  CAS  Google Scholar 

  45. Miller GE, Seale J (1981) Lymphatic clearance during compressive loading, Lymphology 14:161–166

    PubMed  CAS  ISI  Google Scholar 

  46. Ghadially R (1998) Aging and the epidermal permeability barrier: implications for contact dermatitis. Am J Contact Dermatitis 9(3):162–169

    Article  PubMed  CAS  Google Scholar 

  47. Gibson T, Kenedi RM, Craik JE (1965) The mobile micro-architecture of dermal collagen. Br J Surg 52:764–770

    Article  PubMed  CAS  Google Scholar 

  48. Arao H, Obata M, Shimada T, Hagisawa S (1998) Morphological characteristics of the dermal papillae in the development of pressure sores. J Tissue Viability 8(3):17–23

    PubMed  CAS  Google Scholar 

  49. Parry DAD, Barnes GRG, Craig AS (1978) A comparison of the size distribution of collagen fibrils in connective tissues as a function of age and a possible relation between fibril size distribution and mechanical properties. Proc R Soc Biol Sci 203:305–321

    CAS  Google Scholar 

  50. Silver FH, Kato YP, Ohno M, Wasserman AJ (1992) Analysis of mammalian connective tissue: relationship between hierarchical structure and mechanical properties. J Long-Term Effects Med Implants 2(2,3):165–198

    CAS  Google Scholar 

  51. Richey M, Richey HK, Fenske NA (1988) Aging-related skin changes: development and clinical meaning. Geriatrics 43(4):49–64

    PubMed  CAS  ISI  Google Scholar 

  52. Lavker RM, Zheng PS, Dong G (1986) Morphology of aged skin. Dermatol Clin 4(3):379–389

    PubMed  CAS  Google Scholar 

  53. Fenske NA, Conard CB (1988) Aging skin. Am Fam Physician 37(2):219–230

    PubMed  CAS  Google Scholar 

  54. Smith L (1989) Histopathologic characteristics and ultrastructure of aging skin. CUTIS 43:414–423

    PubMed  CAS  ISI  Google Scholar 

  55. Daly CH, Odland GF (1979) Age-related changes in the mechanical properties of human skin. J Invest Dermatol 73:84–87

    Article  PubMed  CAS  Google Scholar 

  56. Gilchrest BA, Murphy GF, Soter NA (1982) Effect of chronologic aging and ultraviolet irradiation on Langerhans cells in human epidermis. J Invest Dermatol 79(2):85–88

    Article  PubMed  CAS  Google Scholar 

  57. Kohn S, Kohn D, Schiller D (1990) Epidermal Langerhans’ cells in elderly patients with decubital ulcers. J Dermatol 17:724–728

    PubMed  CAS  Google Scholar 

  58. Rodriguez GP, Claus-Walker J (1988) Biochemical changes in skin composition in spinal cord injury: a possible contribution to decubitus ulcers. Paraplegia 26:302–309

    PubMed  CAS  ISI  Google Scholar 

  59. Klein L, Dawson MH, Heiple KG (1977) Turnover of collagen in the adult rat after denervation. J Bone Joint Surg 159-A(8):1065–1067

    Google Scholar 

  60. Rodriguez GP, Claus-Walker J, Kent MC, Garza HM (1989) Collagen metabolite excretion as a predictor of bone-and skin-related complications in spinal cord injury. Arch Phys Med Rehabil 70:442–444

    Article  PubMed  CAS  Google Scholar 

  61. Stover SL (1987) Arthritis related interests in spinal cord injury J Rheumatol 14[Suppl 15]:82–88

    Google Scholar 

  62. Tanaka K (1963) Structural changes in the capillary of the skin in chronic spinal cord injured patients examined with vital microscopy. Scientific Report of National Hakone Sanatorium, Japan, pp 222–231 (in Japanese)

    Google Scholar 

  63. Van Den Hoogen F, Brawn LA, Sherriff S, Watson N, Ward JD (1986 ) Artovenous shunting in quadriplegia. Paraplegia 24:282–286

    PubMed  Google Scholar 

  64. Fischer TW, Wggger-AAlbbrti W, Elsner P (2001) Assessmment of ‘dry skin’: Current bioengineering methods and test designs. Skin Pharmacol Appl Skin Physiol 14:183–195

    Article  PubMed  CAS  Google Scholar 

  65. Blank IH (1953) Further observation on factors which influence the water content of stratum corneum. I Invest Dermatol 259–269

    Google Scholar 

  66. Wildnauer RH, Bothwell JW, Douglass AB (1971) Stratum corneum biomechanical properties. I. Inflfluence of relative humidity on normal and extracted human stratum corneum. J Invest Dermatol 56(1):72–78

    Article  PubMed  CAS  Google Scholar 

  67. Allman RM, Laprade CA, Noel LB, Walker JM, Moorer CA, Dear MR, Smith CR (1986) Pressure sores among hospitalized patients. Ann Int Med 195:337–342

    Google Scholar 

  68. Berlowitz DR, Wilking SVB (1989) Risk factors for pressure sores: A comparison of cross-sectional and cohort-derived data. J Am Geriatr Soc 37:1043–1050

    PubMed  CAS  Google Scholar 

  69. Yarkony GM (1993) Aging skin, pressure ulcers and spinal cord injury, In: Whitenock GG et al (eds) Aging with spinal cord injury. Demos, New York, pp 39–52

    Google Scholar 

  70. Sanders JE, Goldstein BS (2001) Collagen fibril diameters increase and fibril densities decrease in skin subjected to repetitive compressive and shear stresses. J Biomechanics 34:1581–1587

    Article  CAS  Google Scholar 

  71. Wang YH, Sanders JE (2003) How does skin adapt to repetitive mechanical stress to become load tolerant? Med Hypotheses 61(1):29–35

    Article  PubMed  Google Scholar 

  72. Shea JD (1975) Pressure sores classiffication and management. Clin Orthop 112:89–100

    PubMed  Google Scholar 

  73. Vermillion C (1990) Operating room acquired pressure ulcers. Decubitus 3(l):26–30

    PubMed  CAS  Google Scholar 

  74. Witkowski JA, Parish LC (1982) Histopathology of the decubitus ulcer. J Am Acad Dermatol 6:1014–1021

    Article  PubMed  CAS  Google Scholar 

  75. Barnett SE (1987) Histology of the human pressure sore. CARE — Science and Practice 5:13–18

    Google Scholar 

  76. Moore JC, Ray AK, Shakespeare PG (1993) Ultrastructure of human dermis and wounds. Br J Plast Surg 46:460–465

    Article  PubMed  CAS  Google Scholar 

  77. Shimamura K, Watanabe H (2001) Histological study of pressure ulcers from cadaver sacral skin with special reference to the site of initial pathological changes and the progress of the tissue damage. Jpn J P U 3(3):305–314 (English abstract)

    Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Nursing, Kumamoto Health Science University, Izumi 325, Kumamoto, 865-5598, Japan

    Satsue Hagisawa

  2. School of Nursing, Oita University, Hasama 1-1, Oita, 879-5593, Japan

    Tatsuo Shimada

Authors
  1. Satsue Hagisawa
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  2. Tatsuo Shimada
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Editor information

Editors and Affiliations

  1. Department of Engineering & IRC in Biomedical Materials, Queen Mary University of London, Mile End Road, London, E1 4NS, UK

    Dan L. Bader PhD, DSc

  2. Biomedical Engineering Department, Eindhoven University of Technology, Den Dolech 2, P/O Box 513, 5600 MB, Eindhoven, The Netherlands

    Carlijn V.C. Bouten PhD  & Cees W.J. Oomens PhD  & 

  3. Rehabilitation Hospital, Centre de l’Arche, 72650, Saint Saturnin, Le Mans, France

    Denis Colin MD (Medical Director) (Medical Director)

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Hagisawa, S., Shimada, T. (2005). Skin Morphology and Its Mechanical Properties Associated with Loading. In: Bader, D.L., Bouten, C.V., Colin, D., Oomens, C.W. (eds) Pressure Ulcer Research. Springer, Berlin, Heidelberg. https://doi.org/10.1007/3-540-28804-X_11

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  • DOI: https://doi.org/10.1007/3-540-28804-X_11

  • Publisher Name: Springer, Berlin, Heidelberg

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  • Online ISBN: 978-3-540-28804-6

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