Cytokine IL1α and lactate as markers for tissue damage in spineboard immobilisation. A prospective, randomised open-label crossover trial
Cytokine IL1α and lactate as markers for tissue damage in spineboard immobilisation. A prospective, randomised open-label crossover trial
Background
Spinal immobilisation using a rigid long spineboard is a well-established procedure in trauma care. During immobilisation, the body is exposed to high tissue-interface pressures. This may lead to a localised inflammatory response of the skin, which may be used to monitor the body's response to different types of immobilisation device.
Aim
In this study we compared the standard rigid spineboard with a new soft-layered spineboard regarding tissue-interface pressures, skin redness as an indicator of reactive hyperaemia and cutaneous IL1α and lactate release.
Methods
Twelve healthy male participants were asked to lie supine on both a rigid and a soft-layered spineboard, loading the sacrum for one hour, followed by one hour in unloaded position. Tissue-interface pressures on the buttocks during loading were measured continuously using a pressure mapping mat. Cutaneous IL1α and lactate concentrations were assessed using Sebutapes, during 20-minute periods. After each 20-minute period, a photo of the buttocks was taken, which was later assessed for redness by two observers.
Results
Significant differences in tissue-interface pressure and reactive hyperaemia were found between the two types of spineboard. Release of IL1α and lactate were found to increase with prolonged exposure to pressure, and to decrease in the unloaded prone position. A significant relationship was found between tissue-interface pressure and reactive hyperaemia, but not with IL1α nor lactate release. Time course of IL1α and lactate release was similar for both types of spineboard.
Conclusions
IL1α and lactate both have a strong relationship with pressure exposure time, but not with pressure magnitude. Furthermore, IL1α was measured even in the absence of visible redness of the skin. The study offers the potention of biomarkers, reflecting inflammation and/or tissue metabolism, for use in assessing the effects of prolonged spineboard support.
82-88
Hemmes, Baukje
f784389a-f318-46b2-943c-65801fc3df5f
de Wert, Luuk A.
6c404e36-e471-4da1-8c8c-7dd743f2e283
Brink, Peter R.G.
4894dfb7-b24e-480c-a3d5-010a8883e956
Oomens, Cees W. J.
b4884336-5230-4055-9df2-5400c1c57018
Bader, Daniel
9884d4f6-2607-4d48-bf0c-62bdcc0d1dbf
Poeze, Martijn
169d77d9-e50f-4344-95fd-0fbc5472f57f
November 2017
Hemmes, Baukje
f784389a-f318-46b2-943c-65801fc3df5f
de Wert, Luuk A.
6c404e36-e471-4da1-8c8c-7dd743f2e283
Brink, Peter R.G.
4894dfb7-b24e-480c-a3d5-010a8883e956
Oomens, Cees W. J.
b4884336-5230-4055-9df2-5400c1c57018
Bader, Daniel
9884d4f6-2607-4d48-bf0c-62bdcc0d1dbf
Poeze, Martijn
169d77d9-e50f-4344-95fd-0fbc5472f57f
Hemmes, Baukje, de Wert, Luuk A., Brink, Peter R.G., Oomens, Cees W. J., Bader, Daniel and Poeze, Martijn
(2017)
Cytokine IL1α and lactate as markers for tissue damage in spineboard immobilisation. A prospective, randomised open-label crossover trial.
Journal of the Mechanical Behavior of Biomedical Materials, 75, .
(doi:10.1016/j.jmbbm.2017.06.026).
Abstract
Background
Spinal immobilisation using a rigid long spineboard is a well-established procedure in trauma care. During immobilisation, the body is exposed to high tissue-interface pressures. This may lead to a localised inflammatory response of the skin, which may be used to monitor the body's response to different types of immobilisation device.
Aim
In this study we compared the standard rigid spineboard with a new soft-layered spineboard regarding tissue-interface pressures, skin redness as an indicator of reactive hyperaemia and cutaneous IL1α and lactate release.
Methods
Twelve healthy male participants were asked to lie supine on both a rigid and a soft-layered spineboard, loading the sacrum for one hour, followed by one hour in unloaded position. Tissue-interface pressures on the buttocks during loading were measured continuously using a pressure mapping mat. Cutaneous IL1α and lactate concentrations were assessed using Sebutapes, during 20-minute periods. After each 20-minute period, a photo of the buttocks was taken, which was later assessed for redness by two observers.
Results
Significant differences in tissue-interface pressure and reactive hyperaemia were found between the two types of spineboard. Release of IL1α and lactate were found to increase with prolonged exposure to pressure, and to decrease in the unloaded prone position. A significant relationship was found between tissue-interface pressure and reactive hyperaemia, but not with IL1α nor lactate release. Time course of IL1α and lactate release was similar for both types of spineboard.
Conclusions
IL1α and lactate both have a strong relationship with pressure exposure time, but not with pressure magnitude. Furthermore, IL1α was measured even in the absence of visible redness of the skin. The study offers the potention of biomarkers, reflecting inflammation and/or tissue metabolism, for use in assessing the effects of prolonged spineboard support.
Text
Cytokine IL1α and lactate as markers for tissue damage in spineboard immobilisation. A prospective, randomised open-label crossover trial
- Accepted Manuscript
More information
Accepted/In Press date: 20 June 2017
e-pub ahead of print date: 23 June 2017
Published date: November 2017
Organisations:
Researcher Development
Identifiers
Local EPrints ID: 411999
URI: http://eprints.soton.ac.uk/id/eprint/411999
ISSN: 1751-6161
PURE UUID: ce8debd3-a0da-43c1-9fce-f20d7772ad74
Catalogue record
Date deposited: 04 Jul 2017 16:31
Last modified: 16 Mar 2024 05:29
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Contributors
Author:
Baukje Hemmes
Author:
Luuk A. de Wert
Author:
Peter R.G. Brink
Author:
Cees W. J. Oomens
Author:
Martijn Poeze
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