The biomechanical protective effects of a treatment dressing on the soft tissues surrounding a non‐offloaded sacral pressure ulcer
The biomechanical protective effects of a treatment dressing on the soft tissues surrounding a non‐offloaded sacral pressure ulcer
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治疗敷料对非卸载骶骨压疮周围软组织的生物力学保护作用
DOI：
10.1111/iwj.13082
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发表时间：
2019
影响因子：
3.1
通讯作者：
A. Gefen
中科院分区：
文献类型：
--
作者：
Dafna Schwartz;A. Gefen
不能活动的患者在他们的身体支撑接触区域长期承受与体重相关的压缩、拉伸和剪切负荷，随着时间的推移，可能会导致压疮(PU)的发生。大约三分之一的常见骶骨脓液是严重的，并被归类为3或4类。如果发生PU，卸载是基本的、普遍接受的临床干预措施；然而，在许多情况下，完全卸载骶骨脓液是不可能的。最大限度地减少伤口及其周围环境暴露在高机械负荷下是愈合的关键。因此，在本研究中，我们旨在研究不同治疗敷料的结构和机械性能对仰卧位患者未卸载的骶骨PU周围软组织中应力的生物力学影响。使用一种新的三维解剖逼真有限元模型框架，我们比较了三种敷料设计的性能：(A)Meppeex Edge Sacrum(MBS)多层各向异性硅胶泡沫敷料(Mölnlycke Health Care)，(B)各向同性刚性敷料，和(C)各向同性弹性敷料。使用我们新开发的用于评估预防和治疗敷料的保护功效指数(PEI)和加重指数(AI)，我们确定MBS敷料的各向异性僵硬特征是一个关键的设计元素。
Patients who are immobile endure prolonged bodyweight‐related compressive, tensional and shear loads at their body‐support contact areas that over time may lead to the onset of pressure ulcers (PUs). Approximately, one‐third of the common sacral PUs are severe and classified as category 3 or 4. If a PU has occurred, off‐loading is the basic, commonly accepted clinical intervention; however, in many situations, complete off‐loading of sacral PUs is not possible. Minimising the exposure of wounds and their surroundings to elevated mechanical loads is crucial for healing. Accordingly, in the present study, we aimed to investigate the biomechanical effects of the structural and mechanical properties of different treatment dressings on stresses in soft tissues surrounding a non‐offloaded sacral PU in a supine patient. Using a novel three‐dimensional anatomically realistic finite element modelling framework, we have compared performances of three dressing designs: (a) The Mepilex Border Sacrum (MBS) multilayer anisotropic silicone foam dressing (Mölnlycke Health Care), (b) an isotropic stiff dressing, and (c) an isotropic flexible dressing. Using our newly developed protective efficacy index (PEI) and aggravation index (AI) for assessing prophylactic and treatment dressings, we identified the anisotropic stiffness feature of the MBS dressing as a key design element.
DOI：
10.1115/1.4005694
发表时间：
2012-01-01
影响因子：
1.7
作者：
Maas, Steve A.;Ellis, Benjamin J.;Weiss, Jeffrey A.
通讯作者：
Weiss, Jeffrey A.