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Skin epidermal and microvascular properties at the sacrum and heel assessed with optical coherence tomography

Skin epidermal and microvascular properties at the sacrum and heel assessed with optical coherence tomography
Skin epidermal and microvascular properties at the sacrum and heel assessed with optical coherence tomography
Introduction: the sacrum and posterior heel are two common areas where skin is exposed to pressure and shear forces which could lead to damage in the form of pressure ulcers. Despite their vulnerability, relatively few studies have explored their structural and physiological properties which predispose them to damage. The aim of this study was to characterise age- and anatomical site differences in the skin epidermal properties and microvasculature using optical coherence tomography (OCT), in younger and older adults.

Methods: twenty-two younger (18-35 years) and 19 older healthy adults (55-70 years) completed three experimental visits, comprising of non-invasive OCT imaging to characterize skin epidermal properties and microvascular density. Extracted parameters from the captured images were optical attenuation coefficient (OAC), dermal brightness, epidermal thickness, surface roughness (Rq), microvascular plexus depth (µm) and vascular density (%).

Results: there were significant differences in the epidermal structural properties between the sacrum and heel across all parameters (P<0.001), except for roughness (P>0.05). The vascular density profiles plotted against skin depth were also significantly different between anatomical sites (P<0.001), with peak vascular density being more superficial in the heel: ~0.2mm vs. sacrum: ~0.4mm; (P<0.001). The sacrum had a greater maximum vascular density (~9%) compared to the heel (~7%; P<0.001). No significant differences were observed between the age groups (P>0.05).

Conclusion: distinct differences were observed for epidermal and vascular density measurements between heel and sacral skin sites. However, there were no age-related differences, which may be associated with the older adult range (55-70 years) and healthy status. The structural and microvasculature insights could aid in the design of therapeutic interventions to promote tissue viability and health such as site-specific dressing and textiles.
Pressure ulcer, tissue viability, microvasculature, skin aging, epidermal properties
1660-5527
Gordon, Ralph
00e4cfb1-43a6-4702-acd1-e6f2643f7531
Stevens, Charlotte
ffdab1ae-b032-4406-a5bd-c425c4b683b7
Worsley, Pete
6d33aee3-ef43-468d-aef6-86d190de6756
Filingeri, Davide
42502a34-e7e6-4b49-b304-ce2ae0bf7b24
Gordon, Ralph
00e4cfb1-43a6-4702-acd1-e6f2643f7531
Stevens, Charlotte
ffdab1ae-b032-4406-a5bd-c425c4b683b7
Worsley, Pete
6d33aee3-ef43-468d-aef6-86d190de6756
Filingeri, Davide
42502a34-e7e6-4b49-b304-ce2ae0bf7b24

Gordon, Ralph, Stevens, Charlotte, Worsley, Pete and Filingeri, Davide (2026) Skin epidermal and microvascular properties at the sacrum and heel assessed with optical coherence tomography. Skin Pharmacoloy and Physiology. (doi:10.1159/000550488).

Record type: Article

Abstract

Introduction: the sacrum and posterior heel are two common areas where skin is exposed to pressure and shear forces which could lead to damage in the form of pressure ulcers. Despite their vulnerability, relatively few studies have explored their structural and physiological properties which predispose them to damage. The aim of this study was to characterise age- and anatomical site differences in the skin epidermal properties and microvasculature using optical coherence tomography (OCT), in younger and older adults.

Methods: twenty-two younger (18-35 years) and 19 older healthy adults (55-70 years) completed three experimental visits, comprising of non-invasive OCT imaging to characterize skin epidermal properties and microvascular density. Extracted parameters from the captured images were optical attenuation coefficient (OAC), dermal brightness, epidermal thickness, surface roughness (Rq), microvascular plexus depth (µm) and vascular density (%).

Results: there were significant differences in the epidermal structural properties between the sacrum and heel across all parameters (P<0.001), except for roughness (P>0.05). The vascular density profiles plotted against skin depth were also significantly different between anatomical sites (P<0.001), with peak vascular density being more superficial in the heel: ~0.2mm vs. sacrum: ~0.4mm; (P<0.001). The sacrum had a greater maximum vascular density (~9%) compared to the heel (~7%; P<0.001). No significant differences were observed between the age groups (P>0.05).

Conclusion: distinct differences were observed for epidermal and vascular density measurements between heel and sacral skin sites. However, there were no age-related differences, which may be associated with the older adult range (55-70 years) and healthy status. The structural and microvasculature insights could aid in the design of therapeutic interventions to promote tissue viability and health such as site-specific dressing and textiles.

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Skin Pharmacology and Physiology_accepted manuscript - Accepted Manuscript
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More information

Accepted/In Press date: 8 January 2026
e-pub ahead of print date: 19 January 2026
Keywords: Pressure ulcer, tissue viability, microvasculature, skin aging, epidermal properties

Identifiers

Local EPrints ID: 509485
URI: http://eprints.soton.ac.uk/id/eprint/509485
ISSN: 1660-5527
PURE UUID: f13678de-d0a1-4bc9-a412-46daa3915727
ORCID for Ralph Gordon: ORCID iD orcid.org/0000-0002-8441-9292
ORCID for Charlotte Stevens: ORCID iD orcid.org/0009-0009-7612-6228
ORCID for Pete Worsley: ORCID iD orcid.org/0000-0003-0145-5042
ORCID for Davide Filingeri: ORCID iD orcid.org/0000-0001-5652-395X

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Date deposited: 24 Feb 2026 17:43
Last modified: 25 Feb 2026 03:12

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Contributors

Author: Ralph Gordon ORCID iD
Author: Charlotte Stevens ORCID iD
Author: Pete Worsley ORCID iD

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