Effects of two different fabrics on skin barrier function under real pressure conditions.

Background: Pressure Ulcers (PUs) are a severe form of skin and soft tissue lesions, caused by sustained deformation. PU development is complex and depends on different factors. Skin structure and function change during prolonged loading on PU predilection sites and surfaces being in direct contact with skin are likely to have an impact as well. Little is known about the influence of fabrics on skin function under pressure conditions.

Objectives: To investigate skin responses to sustained loading in a sitting position and possible differences between two fabrics.

Methods: Under controlled conditions 6 healthy females (median age 65.0 (61.0-67.8) years) followed a standardized immobilization protocol of a sitting position for 45 min on a spacer and on a cotton fabric. Before and after the loading period skin surface temperature, stratum corneum hydration, transepidermal water loss (TEWL), erythema, skin elasticity and 'relative elastic recovery' were measured at the gluteal areas.

Results: A 45 min sitting period caused increases of skin surface temperature and erythema independent of the fabric. Loading on spacer fabric showed a two times higher increase of TEWL compared to cotton. Stratum corneum hydration showed slight changes after loading, skin elasticity and 'relative elastic recovery' remained stable.

Conclusions: Sitting on a hard surface causes skin barrier changes at the gluteal skin in terms of stratum corneum hydration and TEWL. These changes are influenced by the fabric which is in direct contact to the skin. There seems to be a dynamic interaction between skin and fabric properties especially in terms of temperature and humidity accumulation and transport.