Effects of Skin Microclimate Changes on Skin Condition in Healthy Adults

Abstract

Purpose: The purpose of this study was to examine the effects of moisture, as a skin microclimate variable, at the skin-support surface interface on repeated measures of skin erythema, stratum corneum hydration and skin temperature at pressure-prone areas of healthy adults.

Design: Quasi-experimental repeated measures study.

Subjects and setting: Forty-eight healthy adults participated in a single center-controlled study conducted in a simulated hospital setting in an urban setting (Melbourne, Australia). This research project was conducted from November 2021 to June 2022.

Methods: The effects of moisture and intermittent pressure-loading on skin overlying the sacrum, heels, and elbows were investigated. Participants followed a standardized immobilization protocol of 60 minutes, with 10-minute brief pressure off-loading, in the semi-recumbent position on a standard hospital bed/mattress. The intervention comprised laying with the sacrum in contact with an absorbent pad saturated with normal saline; control skin sites (elbows and heels) were not exposed to the moistened absorbent pad. Skin measures were obtained consecutively at each anatomical testing site upon brief off-loading. Linear mixed models (LMMs) were used to compare skin parameters over time and between conditions.

Results: Differences in stratum corneum hydration scores between control and intervention conditions at the sacrum were significant (P = .001). Differences in erythema and skin temperature scores between control and intervention conditions at the sacrum did not significantly differ; however, significant changes in skin temperature (P = .025) at the sacrum were observed at the 10-minute measurement intervals over 1 hour in the sample, suggesting change in skin temperature over time. No participant displayed non-blanching erythema as a subjective indicator of skin injury in any of the testing conditions.

Conclusions: Skin moisture/wetness, over a period of 1 hour, does not appear to impact erythema and skin temperature at the sacrum. In contrast, the introduction of moisture at the sacrum significantly increases sacral stratum corneum hydration. Study findings suggest that more frequent monitoring cycles of wet sacral skin may be required to identify moisture-associated skin changes.