Department of Biomedical Engineering, Faculty of Engineering, Tel Aviv University, Tel Aviv, Israel.
Charité-Universitätsmedizin Berlin, Department of Dermatology and Allergy, Clinical Research Center for Hair and Skin Science, Berlin, Germany.
Int Wound J. 2019 Aug;16(4):1000-1008. doi: 10.1111/iwj.13137. Epub 2019 May 7.
The use of sacral dressings for pressure ulcer prevention is growing rapidly. In addition to their passive biomechanical role in pressure and shear reduction, in the near future, prophylactic dressings may also provide active tissue protection by releasing preventive agents or drugs into skin and deeper tissues. We investigated delivery of sodium pyruvate (NaPy) from an active dressing to potentially protect the sacral skin and underlying tissues in addition. We used four finite element model variants describing different skin roughness levels to determine time profiles of NaPy diffusion from the dressing into the skin layers. The NaPy concentrations for the different modelled cases stabilised after 1 to 6.5 hours from the time of application of the dressings, at 1% to 3% of the NaPy concentration in the dressing reservoir, which is considered potent. We conclude that prophylactic sacral dressings have the potential to deliver NaPy into skin and subdermally, to potentially increase soft tissue tolerance to sustained bodyweight-caused cell and tissue deformations. The time durations to achieve the steady-state potent NaPy dermal concentrations are clinically feasible, for example, for preparation of patients for surgery or for use in intensive care units.
用于预防压疮的骶部敷料的使用正在迅速增加。除了在减少压力和剪切方面的被动生物力学作用外，在不久的将来，预防性敷料还可以通过将预防剂或药物释放到皮肤和更深的组织中提供主动的组织保护。我们研究了从活性敷料中向骶部皮肤和下面的组织释放丙酮酸钠 (NaPy) 的情况，以提供额外的保护。我们使用了四个描述不同皮肤粗糙度水平的有限元模型变体，以确定 NaPy 从敷料扩散到皮肤层的时间曲线。在敷料应用后的 1 至 6.5 小时内，不同模型案例中的 NaPy 浓度稳定下来，达到敷料储液器中 NaPy 浓度的 1%至 3%，这被认为是有效的。我们得出结论，预防性骶部敷料有可能将 NaPy 输送到皮肤和皮下组织中，从而有可能提高软组织对持续的体重引起的细胞和组织变形的耐受能力。达到稳定的有效 NaPy 真皮浓度所需的时间持续时间在临床上是可行的，例如，为手术准备患者或在重症监护病房使用。
