Ralph is a physiologist with a PhD in thermal and neuromuscular physiology. He is part of the Skin Sensing Research Group based in the Clinical Academic Facility at Southampton General Hospital. Ralph undertook his postdoctoral research within the Skin Sensing Research Group leading on a Medical Research Council funded project exploring the influence of localised temperature on tissue viability, before undertaking a lectureship.

Ralph’s research aims to investigate complex thermomechanical interactions at the skin interface with application to healthy and clinical populations.

Presentation at The Society of Tissue Viability 2025 Conference

The influence of localised cooling at the skin of the heel and sacrum

Objectives

After attending this session, persons will be able to:

• Outline the influence of microclimate on tissue viability
• Understand how pressure and shear and influenced by local temperature changes
• Evaluate the implications for patient care and health

Abstract

It is well established that some of the main contributors to the development of pressure ulcers are localised sustained pressure in combination with shearing forces at the skin. Much research has explored the aetiology of mechanical loading and subsequent strategies to minimise skin damage from sustained pressure exposure. Comparatively, less is known about the interaction of shearing forces and how these may reduce tolerance of human skin.

The management of microclimate conditions at the skin interface are important factors in the prevention of pressure ulcers. Elevated temperature and humidity at the skin compromise its strength and integrity, by reducing its mechanical stiffness and increasing frictional forces at the skin interface. Conversely, the use of localised cooling may offer a promising intervention to mitigate some of these effects.

This presentation will provide an overview of research investigating the use of localised cooling on the pathophysiological responses to mechanical loading and shearing forces. This will include data from a Medical Research Council funded project exploring application at two clinically relevant sites, the sacrum and the heel.

Empirical understanding of the pathophysiological responses to pressure and shear and the potentially beneficial use of localised cooling could lead to the development of therapeutic treatments. It is hoped this will improve patient care and lessen the burden of pressure ulcers.