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混合支撑面预防仰卧位患者骶部压疮的生物力学效果。

The biomechanical efficacy of a hybrid support surface in protecting supine patients from sacral pressure ulcers.

机构信息

Department of Biomedical Engineering, Faculty of Engineering, Tel Aviv University, Tel Aviv, Israel.

出版信息

Int Wound J. 2023 Oct;20(8):3148-3156. doi: 10.1111/iwj.14192. Epub 2023 Apr 18.

Abstract

Support surfaces are the most important pressure ulcer/injury prevention technology available to clinicians for protecting their at-risk patients. A hybrid support surface marries the benefits of reactive and active support surfaces, by using high-quality foam material inside inflatable air cells. When used in its "static mode", it is a constant low air pressure mattress which delivers pressure redistribution in response to patient bodyweight and movements, by maximising the immersion and envelopment performance of the support surface. When used in its powered "dynamic mode", this system further delivers alternating pressure care via the connected foam and air cells. Modes of action of hybrid support surfaces were never studied quantitatively before, excluding through the limited scope of interface pressure mapping. In this work, we developed a novel computational modelling framework and simulations to visualise and quantify the state of soft tissue loading at the buttocks of a supine patient positioned on a hybrid support surface, in both the static and dynamic modes. We found that the dynamic mode effectively shifts deep concentrated soft tissue loading from under the sacral bone (towards the sacral promontory) to the tip of the sacrum (coccyx) and vice versa, and thereby, generates a deep tissue offloading effect.

摘要

支撑表面是临床医生可用于保护高危患者的最重要的压疮/损伤预防技术。混合支撑表面通过在充气气室内部使用高质量的泡沫材料,将反应式和主动式支撑表面的优点结合在一起。在“静态模式”下,它是一种恒定的低气压床垫,通过最大限度地提高支撑表面的沉浸和包裹性能,根据患者体重和运动来实现压力重新分布。在其“动力模式”下,该系统通过连接的泡沫和空气室进一步提供交替压力护理。在这项工作之前,混合支撑表面的作用模式从未被定量研究过,除了通过有限的界面压力映射范围。在这项工作中,我们开发了一种新的计算建模框架和模拟,以可视化和量化仰卧患者臀部在混合支撑表面上处于静态和动态模式时的软组织受力状态。我们发现,动力模式有效地将深部集中的软组织受力从骶骨下方(朝向骶骨岬)转移到骶骨尖端(尾骨),反之亦然,从而产生深部组织减压效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5603/10502263/0f236a3927a2/IWJ-20-3148-g001.jpg

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