Department of Biomedical Engineering, Faculty of Engineering, Tel Aviv University, Tel Aviv, Israel.
Int Wound J. 2022 Nov;19(7):1786-1796. doi: 10.1111/iwj.13783. Epub 2022 Mar 4.
Pressure ulcers are soft-tissue damage associated with tissue exposure to sustained deformations and stress concentrations. In patients who are proned for ventilation or surgery, such damage may occur in the superficial chest tissues that are compressed between the rib cage and the support surface. Prophylactic dressings have been previously proven as generally effective for pressure ulcer prevention. In this study, our goal was to develop a novel computational modelling framework to investigate the biomechanical efficacy of a dressing with a soft cellulose fluff core in protecting proned surgical patients from chest pressure ulcers occurring on the operating table, due to body fixation by the Relton-Hall frame. We compared the levels of mechanical compressive stresses developing in the soft chest tissues, above the sternum and ribs, due to the trunk weight, whilst the body is supported by the Relton-Hall frame pads, with versus without the prophylactically applied bilateral dressings. The protective efficacy index for the extremely high stresses, above the 95th-percentile, were 40.5%, 25.6% and 24.2% for skin, adipose and muscle, respectively, indicating that the dressings dispersed elevated soft-tissue stresses. The current results provide additional support for using soft cellulose fluff core dressings for pressure ulcer prophylaxis, including during surgery.
压力性溃疡是与组织暴露于持续变形和应力集中有关的软组织损伤。在需要俯卧通气或手术的患者中，这种损伤可能发生在胸骨和支撑面之间受压的浅层胸部组织中。预防性敷料以前已被证明对预防压力性溃疡一般有效。在这项研究中，我们的目标是开发一种新的计算建模框架，以研究一种带有柔软纤维素绒毛芯的敷料在保护俯卧手术患者免受因 Relton-Hall 框架固定身体而导致的手术台上胸部压力性溃疡方面的生物力学效果。我们比较了在 Relton-Hall 框架垫支撑下，由于躯干重量，胸骨和肋骨上方的柔软胸部组织中机械压缩应力的水平，同时应用和不应用预防性双侧敷料。极高压力（超过第 95 个百分位数）的保护效果指数分别为皮肤、脂肪和肌肉的 40.5%、25.6%和 24.2%，表明敷料分散了升高的软组织压力。目前的结果为使用柔软纤维素绒毛芯敷料预防压力性溃疡提供了额外的支持，包括在手术期间。
