Page 12 - Mobility Management, November 2018

ATP Series
Microclimate & Temperature
4. DISTRESSED CELLS SEND OUT SIGNALS
As someone who has closely studied how cells ideally live, communicate and die, Bowden said, “They take their signals essentially from chemical responses. Those responses tells them if everything is okay in their world or not.
“When pressure is introduced to the surface of the skin,
cells receive signals that tell them that their environment has changed,” she added. “Cells live in a very specific environment, and they are heavily influenced by blood flow, oxygen, moisture and deformation. Cellular death may be triggered if any of these variables are substantially altered.”
In simple terms, if the cell determines that its current environ- ment is insufficient, the cell will begin to die. This action is the start of a pressure injury.
“Heat and moisture may accelerate cellular breakdown,” Bowden said. “They don’t like to be deformed, they don’t like to be hot. So when there’s heat, not only are cells not in the optimal environment they’re used to, but the sweating affects the elas- ticity of the cells.”
Fortunately, relatively small changes can make a big difference in cell survival. For example, Bowden noted that cooling a microclimate’s temperature by just 1° Celsius can slow skin breakdown.
Cells live in a very specific environment, and they are heavily influenced by blood flow, oxygen, moisture and deformation
— Barbara Bowden
“When you have heat, that can accelerate the cell-death cycle,” she said. “All the other cells are getting those chemical signals faster, and they’re dying faster as well. So if you can lower the heat in that microclimate, you’re saving those cells from acceler- ating their breakdown.”
5. PRESSURE RELIEF TACTICS CAN HELP
Fortunately, a regimen that should already be part of every wheelchair user’s routine can have a great impact on managing microclimate.
“The number one way to prevent microclimate from adversely affecting a patient is to do weight shifts and pressure reliefs,” Bowden said. “It’s the best way to mitigate that temperature and
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12 NOVEMBER2018|MOBILITYMANAGEMENT
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