The false premise in measuring body-support interface pressures for preventing serious pressure ulcers

A. Gefen*, J. Levine

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

42 Scopus citations

Abstract

Presently, commercial cushioning products for pressure ulcer prevention are being evaluated for their protective effect exclusively based on interfacial pressures between the cushion/mattress and the patient. However, interface pressures cannot predict elevated mechanical stresses in deep tissues adjacent to bony prominences. Such deep tissue stress concentrations are associated with local ischaemia and hypoxia, which over time result in deep tissue necrosis, particularly of muscle tissue. In order to demonstrate this phenomenon, a physical phantom of the mechanical interaction between the ischial tuberosities (IT) and gluteus muscles of the buttocks was built, incorporating geometric replica of the human IT and real (bovine) muscle tissue. Internal muscle stresses directly under the IT were five to 11-fold greater than stresses at more distal locations, and a Pearson correlation test showed that they could not have been predicted from the interface pressures in the phantom. Accordingly, though pressure ulcer prevention clinics which utilize routine sitting pressure measurements report effective outcomes, the present results highlight a problem in using body-support pressure measurements to predict the risk for pressure-related deep tissue injury.

Original languageEnglish
Pages (from-to)375-380
Number of pages6
JournalJournal of Medical Engineering and Technology
Volume31
Issue number5
DOIs
StatePublished - Sep 2007

Funding

FundersFunder number
Tel Aviv University

    Keywords

    • Bedsore
    • Decubitus ulcer
    • Paralysis
    • Pressure sore
    • Pressure-related deep tissue injury
    • Rehabilitation

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