Department of Biomedical Engineering, Faculty of Engineering, Tel Aviv University, Tel Aviv, Israel.
Int Wound J. 2018 Dec;15(6):866-874. doi: 10.1111/iwj.12937. Epub 2018 May 24.
Sustained pressure, shear forces, and friction, as well as elevated humidity/moisture, are decisive physical factors in the development of pressure injuries (PIs). To date, further research is needed in order to understand the influence of humidity and moisture on the coefficient of friction (COF) of skin against different types of medical textiles. The aim of this work was to investigate the effects of moisture caused by sweat, urine, or saline on the resulting COF of skin against different textiles used in the medical setting in the context of PI prevention. For that purpose, we performed physical measurements of static COFs of porcine skin followed by finite element (FE) computational modelling in order to illustrate the effect of increased COF at the skin on the resulting strains and stresses deep within the soft tissues of the buttocks. The COF of dry skin obtained for the 3 textiles varied between 0.59 (adult diaper) and 0.91 (polyurethane dressing). In addition, the COF increased with the added moisture in all of the tested cases. The results of the FE simulations further showed that increased COF results in elevated strain energy density and shear strain values in the skin and deeper tissues and, hence, in an increased risk for PI development. We conclude that moisture may accelerate PI formation by increasing the COF between the skin and the medical textile, regardless of the type of the liquid that is present. Hence, reduction of the wetness/moisture between the skin and fabrics in patients at a high risk of developing PIs is a key measure in PI prevention.
持续的压力、剪切力和摩擦力，以及升高的湿度/水分，是压力性损伤（PI）发展的决定性物理因素。迄今为止，需要进一步的研究来了解湿度和水分对皮肤与不同类型医用纺织品之间的摩擦系数（COF）的影响。这项工作的目的是研究汗水、尿液或生理盐水引起的水分对预防 PI 中使用的不同类型医用纺织品的皮肤 COF 的影响。为此，我们对猪皮的静态 COF 进行了物理测量，然后进行有限元（FE）计算建模，以说明皮肤 COF 增加对臀部软组织深层应变和应力的影响。3 种纺织品的干燥皮肤 COF 介于 0.59（成人纸尿裤）和 0.91（聚氨酯敷料）之间。此外，在所有测试案例中，COF 均随添加的水分而增加。FE 模拟的结果进一步表明，COF 的增加会导致皮肤和更深层组织中的应变能密度和剪切应变值增加，从而增加 PI 发展的风险。我们得出结论，无论存在哪种液体，水分都会通过增加皮肤与医用纺织品之间的 COF 来加速 PI 的形成。因此，减少高风险发生 PI 的患者皮肤与织物之间的潮湿/水分是预防 PI 的关键措施。
