School of Engineering and Materials Science, Queen Mary University of London, London E1 4NS, UK.
J Mech Behav Biomed Mater. 2013 Dec;28:427-35. doi: 10.1016/j.jmbbm.2013.05.014. Epub 2013 Jun 3.
Prolonged mechanical loading can lead to breakdown of skin and underlying tissues which can, in turn, develop into a pressure ulcer. The benefits of pressure relief and/or redistribution to minimise risk have been well documented and these strategies can be provided by employing support mattresses in which internal air pressures can be alternated to minimise the risk of pressure ulcers in patients during prolonged periods of bed-rest. The paper describes the performance of a prototype alternating pressure air mattress (APAM), in terms of its ability to maintain skin viability in a group of healthy volunteers lying in a supine position. In particular, the mattress includes a sacral section supported with alternating low pressure (ALP), with values adjusted to subject morphology, using an in-built pressure sensor. The mattress was supported at four different head of bed (HOB) angles ranging from 0 to 60°. Internal mattress pressures and transcutaneous gas (TcPO2/TcPCO2) tensions at the sacrum and a control site, the scapula, were monitored. Interface pressures were also measured. The sensor was found to be sensitive to the BMI values of the 12 healthy volunteers. In the majority of test conditions the internal support produced sacral TcPO2 values, which either remained similar to those at the scapula or fluctuated at levels providing adequate viability. However in a few cases, associated with a raised HOB angle (≥45°), there was compromise to the skin viability at the sacrum, as reflected in depressed TcPO2 levels associated with an elevation of TcPCO2 levels above the normal range. In all cases, interface pressures at the sacrum rarely exceeded 60mmHg. Although such studies need to be extended to involve bed-bound individuals, the results offer the potential for the development of intelligent APAM systems, whose characteristics can be adjusted to an individual morphology. Such preventive strategies to maintain skin viability at loaded sites will be designed for subjects deemed to be at high risk of developing pressure ulcers.
长时间的机械负荷会导致皮肤和下面的组织受损，这反过来又会发展成压疮。缓解压力和/或重新分配压力以降低风险的好处已经得到了充分的证明，这些策略可以通过使用支撑床垫来实现，其中内部气压可以交替变化，以最大限度地降低卧床休息患者长时间形成压疮的风险。本文描述了一种原型交替压力空气床垫（APAM）的性能，该床垫在一组仰卧位健康志愿者中保持皮肤活力的能力。特别是，床垫包括一个骶骨部分，使用内置压力传感器，通过交替低压（ALP）进行支撑，低压值根据主体形态进行调整。床垫在四个不同的床头（HOB）角度下支撑，角度范围从 0 到 60°。监测骶骨和对照部位肩胛骨的内部床垫压力和经皮气体（TcPO2/TcPCO2）张力。还测量了界面压力。该传感器被发现对 12 名健康志愿者的 BMI 值敏感。在大多数测试条件下，内部支撑产生的骶骨 TcPO2 值要么与肩胛骨的值相似，要么在提供足够活力的水平上波动。然而，在少数情况下，与抬高的 HOB 角度（≥45°）相关，骶骨的皮肤活力受到损害，反映在 TcPO2 水平降低，同时 TcPCO2 水平升高至正常范围以上。在所有情况下，骶骨的界面压力很少超过 60mmHg。尽管此类研究需要扩展到卧床不起的人群，但结果为开发智能 APAM 系统提供了潜力，其特征可以根据个体形态进行调整。这种维持受压部位皮肤活力的预防策略将针对被认为有形成压疮高风险的受试者设计。
