Lateral pressure equalisation as a principle for designing support surfaces to prevent deep tissue pressure ulcers
Lateral pressure equalisation as a principle for designing support surfaces to prevent deep tissue pressure ulcers
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DOI：
10.1101/592477
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发表时间：
2019-03
期刊：
影响因子：
3.7
通讯作者：
C. J. Boyle;D. Carpanen;T. Pandelani;C. Higgins;M. Masen;S. Masouros
中科院分区：
文献类型：
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作者：
C. J. Boyle;D. Carpanen;T. Pandelani;C. Higgins;M. Masen;S. Masouros
当不动或神经病患者由床或椅子支撑时，他们的软组织发生变形，可能导致压疮。目前的支持表面，重新分配身体下的压力在脆弱的身体部位没有成功地减少压疮的患病率。在这里，我们表明，增加一个支持侧压力可以抵消由身体下的压力引起的变形，这种“压力均衡”的方法是一种更有效的方式来减少溃疡诱导变形比目前的方法的基础上重新分配身体下的压力。坐姿骨盆的有限元模型预测，相对于标准衬垫，向软组织施加侧向压力可将深部组织中的峰值von Mises应力降低2.4倍，这比使用更贴合的衬垫所实现的效果更大。峰值侧压力与峰值体下压力的比率被证明比单独的体下压力更好地调节深部组织应力。通过优化侧向压力的大小和位置，组织变形可以减少到悬浮在流体中时引起的变形。我们的研究结果解释了目前的支撑表面缺乏有效性，并提出了一种新的方法来设计和评估支撑表面：确保施加足够的侧向压力来抵消车身底部的压力。
When immobile or neuropathic patients are supported by beds or chairs, their soft tissues undergo deformations that can cause pressure ulcers. Current support surfaces that redistribute under-body pressures at vulnerable body sites have not succeeded in reducing pressure ulcer prevalence. Here we show that adding a supporting lateral pressure can counter-act the deformations induced by under-body pressure, and that this ‘pressure equalisation’ approach is a more effective way to reduce ulcer-inducing deformations than current approaches based on redistributing under-body pressure. A finite element model of the seated pelvis predicts that applying a lateral pressure to the soft tissue reduces peak von Mises stress in the deep tissue by a factor of 2.4 relative to a standard cushion — a greater effect than that achieved by using a more conformable cushion. The ratio of peak lateral pressure to peak under-body pressure was shown to regulate deep tissue stress better than under-body pressure alone. By optimising the magnitude and position of lateral pressure, tissue deformations can be reduced to that induced when suspended in a fluid. Our results explain the lack of efficacy in current support surfaces, and suggest a new approach to designing and evaluating support surfaces: ensuring sufficient lateral pressure is applied to counter-act under-body pressure.