TY - JOUR
T1 - The false premise in measuring body-support interface pressures for preventing serious pressure ulcers
AU - Gefen, A.
AU - Levine, J.
PY - 2007/9
Y1 - 2007/9
N2 - 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.
AB - 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.
KW - Bedsore
KW - Decubitus ulcer
KW - Paralysis
KW - Pressure sore
KW - Pressure-related deep tissue injury
KW - Rehabilitation
UR - http://www.scopus.com/inward/record.url?scp=34548080956&partnerID=8YFLogxK
U2 - 10.1080/03091900601165256
DO - 10.1080/03091900601165256
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AN - SCOPUS:34548080956
SN - 0309-1902
VL - 31
SP - 375
EP - 380
JO - Journal of Medical Engineering and Technology
JF - Journal of Medical Engineering and Technology
IS - 5
ER -