Microclimate: Rediscovering an Old Concept in the Aetiology of Pressure Ulcers

Abstract

That changes of local skin temperature and relative humidity may play a part in predisposing people to pressure ulcer development has long been recognized but perhaps overlooked due to the strong focus upon pressure redistribution. Around 2010 interest has grown in the microclimate and its management within pressure ulcer prevention. There is limited data upon which to base firm conclusions around whether modifying the microclimate influences pressure ulcer development. There is growing data that local skin cooling may reduce the hyperaemic response following unloading while altering some aspects of cytokine production. However these potentially beneficial effects of skin cooling may reduce the patient’s experience and quality of life. Skin-mattress relative humidity may be higher among patients who later develop superficial sacral pressure ulcers compared with other patients who do not develop these injuries. However interpretation of this data is compounded by the wide intra- and inter- individual differences in microclimate parameters. There is a growing need for increased communication between textile and pressure ulcer researchers if progress is to be made in elucidating the role (if any) of the microclimate in pressure ulcer prevention.