Purpose: Nail clipping is a self-care practice with the potential to harm patients with diabetes. Medical staff often recommend that patients use a glass or metal nail file. The former is often recommended in clinical settings without evidence to support the recommendation. Therefore, we herein investigated the effects of glass and metal files on nails. Methods: The present, quasi-experimental study enrolled six, healthy adult subjects . Two types of glass（①, ②）and metal（③ , ④）file were used. Factors, such as the shape of the nail files, their surface contours, marks left on nails after filing, and filing efficiency, i.e., the number of strokes required to file 1 mm of nail, were assessed. Images of the file parts and file marks on nails were qualitatively evaluated. Results: The glass file was thick and inflexible whereas the metal file was thin and had a sharp tip. The filed nail was “uniform” only when type ④ was used. Scratch marks on the nails left by ①, ②, and ③ had the appearance of “lines” while those left by ④ had the appearance of “dots.” For types ①, ②, ③, and ④, the number of strokes required to file 1 mm of nail was 36-54, 62-70, 29-38, and 38-50, respectively. No damage to the nails or the surrounding skin was observed. Discussion: Collectively, the glass and metal files did not differ significantly in terms of the markings or efficiency. However, metal files caused slight skin damage owing to their shape; therefore, caution is required for their use.
Purpose: Dry skin is associated with skin barrier disruption and a risk of inflammatory skin disease. Nurses often rely on their experience and knowledge to assess dry skin, but an objective assessment method is needed for consistent quality care. Objective evaluation indicators for skin dryness using digital image analysis of skin morphology were previously identified in the forearms of older people. This study aimed to determine the usefulness of those indicators and identify an objective indicator that reflects the skin dryness degree in the forearms and lower legs in adults using digital image analysis. Methods: This single-center cross-sectional study（June 2014 to March 2015）was conducted in Tokyo, Japan. Participants’ characteristics were obtained using questionnaires. Skin dryness of the forearms and lower legs was evaluated using electrostatic capacity, whereas skin morphology was measured using digital image analysis. The relationship between electrostatic capacity and skin morphology was analyzed using Spearman’s rank correlation coefficient. Results: This study included 22 different areas of the left and right sides of the forearms or lower legs of the 11 participants. Compared with the forearm, the interval of the sulcus cutis of the lower legs was wider, and the parallelism was lower. The parallelism of the sulcus cutis was negatively correlated with electrostatic capacity in the lower legs（rho = -0.48, p = 0.025）. No correlation was observed between the arms. Discussion: Detecting skin morphology by digital image analysis may be an effective indicator for assessing dry skin of lower legs in adults and improving care.
［Objective］Opening surgical incisions to assess the subcutaneous status of superficial incisional surgical site infections（SSIs）leads to high distress in patients. This study explores the possibility of using thermography for the non-invasive assessment of superficial incisional SSIs. ［Methods］A prospective longitudinal observational study was conducted on patients who had undergone abdominal surgery, on a standby basis, at the gastroenterological surgery center of an institution. The distribution of high-temperature and low-temperature area in the analysis area of the thermographic images was reviewed to obtain the difference in the maximal and minimal temperature on the surgical site（ΔT）. ［Results］295 thermographs of 46 target patients were analyzed. There were three cases of superficial incisional SSIs among the patients. Eight patients showed characteristic low temperature areas（spot-like and chain-like）on the surgical incision. Patients with a spot-like low-temperature area and a difference of 1℃ or more between the highest and lowest temperature in the analysis area（ ΔT）were later diagnosed with superficial incisional SSI, with purulent drainage from the same site. No superficial incisional SSI occurred in the chain-like low-temperature area. No superficial incisional SSIs were observed in patients with chain-like low temperature areas. ［Discussion & Conclusion］The results indicate that it may be possible to detect superficial incisional SSIs at an early stage, where 1℃<ΔT. This suggests that thermography could be useful in the early detection of superficial incisional SSIs after abdominal gastroenterological surgery.