Cervical collars restrict cervical spine movement to minimise the risk of spinal cord injury. Collars apply mechanical loading to the skin putting it at risk of skin damage. Indeed, cervical collar-related pressure ulcers are unacceptably prevalent, especially at the occiput, mandibles, and chin. Collar design and fit are often key considerations for prevention. This comprehensive study evaluated four commercial prehospital and acute care cervical collars. Pressure, microclimate, transepidermal water loss and skin hydration were measured at the interface between the device and the skin. Range of motion restriction was measured to evaluate effective immobilisation. Head, neck, and shoulder morphology was evaluated using three-dimensional scans. The occiput experienced significantly higher interface pressures than the chin and mandibles for most collar designs. Interface pressure at the occiput was significantly higher for the Stiffneck extrication collar compared to the other collar designs. The Stiffneck collar also provided the most movement restriction, though not significantly more than other designs. Relative humidity at the device skin interface was significantly higher for the Stiffneck and Philadelphia collars corresponding to closed cell foam padding, in contrast to the open cell foams lined with permeable fabric used in the other collars. Collar discomfort correlated with both occipital pressure and skin humidity. The occiput is at increased risk of cervical collar-related pressure ulcers during supine immobilisation, especially for Stiffneck extrication collars. Lined open-cell foams could be used to minimise skin humidity and increase comfort.

中文翻译：

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颈托设计和贴合的生物工程研究：对皮肤健康的影响

颈托限制颈椎运动，以尽量减少脊髓损伤的风险。项圈对皮肤施加机械负荷，使其面临皮肤损伤的风险。事实上，与颈托相关的压疮非常普遍，尤其是在枕骨、下颌骨和下巴处。衣领设计和合身通常是预防的关键考虑因素。这项综合研究评估了四种商业院前和急症护理颈托。在设备和皮肤之间的界面处测量压力、微气候、经皮失水和皮肤水合。测量运动限制范围以评估有效的固定。使用三维扫描评估头部、颈部和肩部形态。对于大多数项圈设计，枕骨承受的界面压力明显高于下巴和下颌骨。与其他项圈设计相比，僵颈解救项圈的枕骨处的界面压力明显更高。硬颈衣领也提供了最大的运动限制，尽管并不比其他设计明显更多。与其他项圈中使用的内衬有渗透性织物的开孔泡沫相比，与闭孔泡沫填充相对应的 Stiffneck 和 Philadelphia 项圈在设备皮肤界面处的相对湿度明显更高。衣领不适与枕骨压力和皮肤湿度相关。在仰卧固定期间，枕部发生颈托相关压疮的风险增加，特别是对于僵颈解救项圈。内衬开孔泡沫可用于最大限度地减少皮肤湿度并增加舒适度。