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

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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

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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

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