Bioengineering Methods Of Assessment

Visual inspection and scoring of vulvar irritation reactions may lack the sensitivity to recognize all cases of vulvar skin irritation, including low-grade dermatitis. The visual scoring system ranges from 0 to 4: normal skin, 0; slight redness, spotty or diffuse, 1; moderate, uniform redness, 2; intense redness, 3; and fiery erythema and edema, 4 (4,16). Various bioengineering instruments have enabled scientists to ascertain the vulva's unique skin characteristics objectively.

As mentioned previously, the vulva has increased basal cutaneous blood flow, which may aid in the rapid healing of the vulvar skin after trauma, such as tape stripping. Laser Doppler velocimetry has been used to objectively quantify blood flow in vulvar versus forearm skin. A laser Doppler flowmeter detected the frequency shift (Doppler effect) of He-Ne laser light (A = 632.8 nm) caused by moving blood cells. Monochromatic light undergoes a frequency shift when reflected by the moving blood cells, while stationary tissue does not change the frequency. The reflected light is collected by two optical fibers to a pair of photo electrodes. The dimensionless output signal is proportional to the cutaneous blood flow. The basal skin blood flow was found to be significantly higher in the vulva than the forearm (8,16).

TEWL, as mentioned previously, is a measure of stratum corneum integrity against water loss. It is measured with an evaporimeter that has a hand-held probe with a 1 cm tail extension to reduce air turbulence around the hydrosensors and metallic shield to minimize contamination. The skin is maintained at a standard temperature throughout the measurement. Essentially, the evaporimeter measures the amount of water that evaporates via the skin surface. The electrical capacitance of the skin is an indicator of stratum corneum water content. It is measured with a capacitometer, which consists of a probe applied to the skin with slight pressure for three seconds. The skin capacitance is expressed as a digital readout (16).

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