SKIN HYDRATION, INJURY PREVALENCE AND FREQUENCY: UNDERSTANDING THE INFLUENCE OF PHYSIOLOGIC, BEHAVIORAL AND DEMOGRAPHIC FACTORS
Skin is the largest and most visible organ of the body. It is the direct interface between the external and internal environment. The skin has compensatory mechanisms to sustain its functions, but external threats may make it susceptible to injury. Although increasing evidence describes the biomechanical properties of the skin, limited clinical studies explore the effects of factors on the skin’s outer surface and its susceptibility to injury. Factors associated with skin injury, such as body mass index (BMI), smoking, sun exposure, and age are not always integrated into study designs. This dissertation provided a secondary analysis of pre-existing data (N = 351) from two parent studies describing injury prevalence and frequency in women following consensual sexual intercourse. Data were transferred from the principal investigator of the parent study to this investigator according to human subjects procedures and analyzed using path analysis. Skin hydration was the central focus of the study and is defined as the water content of the stratum corneum. The study showed that both age and BMI were negatively associated with skin hydration, but skin hydration was not a mediator for any of the identified variables, skin color, or viscoelasticity. Additionally, neither the physiologic (BMI), behavioral (smoking and sun exposure) or demographic (age) variables were significantly associated with skin injury prevalence and frequency. Skin color L-value significantly predicted skin injury prevalence, not injury frequency. The results demonstrated that viscoelasticity was not a significant mediator for any relationship between the set predictors and the outcomes of skin injury prevalence and frequency. Viscoelasticity mediated the relationship between age and skin hydration and age was negatively associated with viscoelasticity. Therefore, although skin hydration did not predict skin injury, skin color (i.e., lightness) predicted skin injury prevalence. Further exploration of all related variables is necessary when identifying patients who are at high risk for skin injury. Future knowledge development can inform multi-level interventions that may target modifiable risk factors to maintain the skin’s integrity.