Usage of anthropometry to determine etiological and risk factors in deep-tissue injury

Pressure ulcers, also termed pressure sores, bedsores or decubitus, are a serious complication which is typical of patients with impaired motosensory capacities, and of those confined to a wheelchair or bed for long periods. There is medical evidence associating severe pressure ulcers with life-threatening conditions including sepsis, osteomyelitis, myocardial infarcts, renal failure and multiple organ system failure. The American National Pressure Ulcer Advisory Panel recently defined a deep tissue injury (DTI) as a particularly severe type of pressure ulcer which onsets internally, in skeletal muscle tissue overlying weight-bearing bony prominences. A DTI spreads subdermally and often develops to a full-thickness pressure ulcer, i.e. it evolves into an open wound that extends from skin to bone. This chapter is focused on anthropometric features that increase internal mechanical loading in skeletal muscle tissue adjacent to weight-bearing bony prominences, and therefore, increase the risk for DTI. The ischial tuberosities in the pelvis are being considered herein as the main example for this interaction. Specifically, this chapter reviews the effects of whole-body anthropometric measures, such as the bodyweight and body mass index, as well as effects of internal anthropometric characteristics, e.g. the thickness of the gluteus muscles that envelop the ischial tuberosities, or the curvature of the ischial tuberosities, on the internal mechanical conditions in adjacent skeletal muscle tissue, and on the consequent risk for DTI.