No Thermoregulatory Impairment in Skin Graft Donor Sites during Exercise-Heat Stress

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

The US Army's Standards of Medical Fitness, AR 40-501, state that "Prior burn injury (to include donor sites) involving a total body surface area of 40% or more does not meet the standard." Inclusion of donor sites (sites harvested for skin grafts) in this standard implies that thermoregulatory function is impaired within donor sites during exercise-heat stress; however, supporting evidence is currently lacking. Purpose: To test the hypothesis that well-healed donor and noninjured sites demonstrate similar elevations in skin blood flow and sweating during exercise-induced hyperthermia. Methods: Twenty burn survivors (>1 yr postinjury; four females) cycled for 60 min in a 39.7°C ± 0.3°C and 21.1% ± 3.3% relative humidity environment at approximately 50% of maximal aerobic capacity. Core and mean skin temperatures were recorded throughout exercise. Skin blood flow (laser-Doppler imaging) was measured at baseline and after exercise within donor (LDF DON ) and adjacent noninjured control (LDF CON ) sites. At 45 min of exercise, local sweat rates (Technical Absorbents) were measured within the same donor (LSR DON ) and noninjured (LSR CON ) areas. Results: After 60 min of exercise, core and skin temperatures reached 38.2°C ± 0.4°C and 35.5°C ± 1.2°C, respectively. The increase in skin blood flow from baseline to end-exercise (LDF DON , 91.6 ± 44.5 AU; LDF CON , 106.0 ± 61.6 AU; P = 0.17) and local sweat rates (LSR DON , 0.46 ± 0.26 mg·cm -2 ·min -1 ; LSR CON , 0.53 ± 0.25 mg·cm -2 ·min -1 ; P = 0.14) were not different between donor and noninjured control sites. Conclusions: Well-healed donor sites retain the ability to increase skin blood flow and sweating during exercise heat stress, providing evidence against the inclusion of donor sites when determining whether a burn injury meets the Army's Standards of Medical Fitness.

Original languageEnglish (US)
Pages (from-to)868-873
Number of pages6
JournalMedicine and science in sports and exercise
Volume51
Issue number5
DOIs
StatePublished - May 1 2019

Fingerprint

Hot Temperature
Transplants
Skin
Sweating
Skin Temperature
Sweat
Induced Hyperthermia
Body Surface Area
Wounds and Injuries
Humidity
Lasers

Keywords

  • BURN INJURY
  • BURN SURVIVOR
  • CORE TEMPERATURE
  • SKIN BLOOD FLOW
  • SWEAT RATE

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Physical Therapy, Sports Therapy and Rehabilitation

Cite this

No Thermoregulatory Impairment in Skin Graft Donor Sites during Exercise-Heat Stress. / Cramer, Matthew N.; Moralez, Gilbert; Huang, Mu; Crandall, Craig G.

In: Medicine and science in sports and exercise, Vol. 51, No. 5, 01.05.2019, p. 868-873.

Research output: Contribution to journalArticle

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title = "No Thermoregulatory Impairment in Skin Graft Donor Sites during Exercise-Heat Stress",
abstract = "The US Army's Standards of Medical Fitness, AR 40-501, state that {"}Prior burn injury (to include donor sites) involving a total body surface area of 40{\%} or more does not meet the standard.{"} Inclusion of donor sites (sites harvested for skin grafts) in this standard implies that thermoregulatory function is impaired within donor sites during exercise-heat stress; however, supporting evidence is currently lacking. Purpose: To test the hypothesis that well-healed donor and noninjured sites demonstrate similar elevations in skin blood flow and sweating during exercise-induced hyperthermia. Methods: Twenty burn survivors (>1 yr postinjury; four females) cycled for 60 min in a 39.7°C ± 0.3°C and 21.1{\%} ± 3.3{\%} relative humidity environment at approximately 50{\%} of maximal aerobic capacity. Core and mean skin temperatures were recorded throughout exercise. Skin blood flow (laser-Doppler imaging) was measured at baseline and after exercise within donor (LDF DON ) and adjacent noninjured control (LDF CON ) sites. At 45 min of exercise, local sweat rates (Technical Absorbents) were measured within the same donor (LSR DON ) and noninjured (LSR CON ) areas. Results: After 60 min of exercise, core and skin temperatures reached 38.2°C ± 0.4°C and 35.5°C ± 1.2°C, respectively. The increase in skin blood flow from baseline to end-exercise (LDF DON , 91.6 ± 44.5 AU; LDF CON , 106.0 ± 61.6 AU; P = 0.17) and local sweat rates (LSR DON , 0.46 ± 0.26 mg·cm -2 ·min -1 ; LSR CON , 0.53 ± 0.25 mg·cm -2 ·min -1 ; P = 0.14) were not different between donor and noninjured control sites. Conclusions: Well-healed donor sites retain the ability to increase skin blood flow and sweating during exercise heat stress, providing evidence against the inclusion of donor sites when determining whether a burn injury meets the Army's Standards of Medical Fitness.",
keywords = "BURN INJURY, BURN SURVIVOR, CORE TEMPERATURE, SKIN BLOOD FLOW, SWEAT RATE",
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AU - Huang, Mu

AU - Crandall, Craig G.

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N2 - The US Army's Standards of Medical Fitness, AR 40-501, state that "Prior burn injury (to include donor sites) involving a total body surface area of 40% or more does not meet the standard." Inclusion of donor sites (sites harvested for skin grafts) in this standard implies that thermoregulatory function is impaired within donor sites during exercise-heat stress; however, supporting evidence is currently lacking. Purpose: To test the hypothesis that well-healed donor and noninjured sites demonstrate similar elevations in skin blood flow and sweating during exercise-induced hyperthermia. Methods: Twenty burn survivors (>1 yr postinjury; four females) cycled for 60 min in a 39.7°C ± 0.3°C and 21.1% ± 3.3% relative humidity environment at approximately 50% of maximal aerobic capacity. Core and mean skin temperatures were recorded throughout exercise. Skin blood flow (laser-Doppler imaging) was measured at baseline and after exercise within donor (LDF DON ) and adjacent noninjured control (LDF CON ) sites. At 45 min of exercise, local sweat rates (Technical Absorbents) were measured within the same donor (LSR DON ) and noninjured (LSR CON ) areas. Results: After 60 min of exercise, core and skin temperatures reached 38.2°C ± 0.4°C and 35.5°C ± 1.2°C, respectively. The increase in skin blood flow from baseline to end-exercise (LDF DON , 91.6 ± 44.5 AU; LDF CON , 106.0 ± 61.6 AU; P = 0.17) and local sweat rates (LSR DON , 0.46 ± 0.26 mg·cm -2 ·min -1 ; LSR CON , 0.53 ± 0.25 mg·cm -2 ·min -1 ; P = 0.14) were not different between donor and noninjured control sites. Conclusions: Well-healed donor sites retain the ability to increase skin blood flow and sweating during exercise heat stress, providing evidence against the inclusion of donor sites when determining whether a burn injury meets the Army's Standards of Medical Fitness.

AB - The US Army's Standards of Medical Fitness, AR 40-501, state that "Prior burn injury (to include donor sites) involving a total body surface area of 40% or more does not meet the standard." Inclusion of donor sites (sites harvested for skin grafts) in this standard implies that thermoregulatory function is impaired within donor sites during exercise-heat stress; however, supporting evidence is currently lacking. Purpose: To test the hypothesis that well-healed donor and noninjured sites demonstrate similar elevations in skin blood flow and sweating during exercise-induced hyperthermia. Methods: Twenty burn survivors (>1 yr postinjury; four females) cycled for 60 min in a 39.7°C ± 0.3°C and 21.1% ± 3.3% relative humidity environment at approximately 50% of maximal aerobic capacity. Core and mean skin temperatures were recorded throughout exercise. Skin blood flow (laser-Doppler imaging) was measured at baseline and after exercise within donor (LDF DON ) and adjacent noninjured control (LDF CON ) sites. At 45 min of exercise, local sweat rates (Technical Absorbents) were measured within the same donor (LSR DON ) and noninjured (LSR CON ) areas. Results: After 60 min of exercise, core and skin temperatures reached 38.2°C ± 0.4°C and 35.5°C ± 1.2°C, respectively. The increase in skin blood flow from baseline to end-exercise (LDF DON , 91.6 ± 44.5 AU; LDF CON , 106.0 ± 61.6 AU; P = 0.17) and local sweat rates (LSR DON , 0.46 ± 0.26 mg·cm -2 ·min -1 ; LSR CON , 0.53 ± 0.25 mg·cm -2 ·min -1 ; P = 0.14) were not different between donor and noninjured control sites. Conclusions: Well-healed donor sites retain the ability to increase skin blood flow and sweating during exercise heat stress, providing evidence against the inclusion of donor sites when determining whether a burn injury meets the Army's Standards of Medical Fitness.

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