Spiteri Maegan, Boyle Colin, Caggiari Silvia, Christou Alexandros, Savine Louise, Worsley Peter R, Masouros Spyros
Department of Bioengineering, Imperial College London, UK.
Skin Sensing Research Group, School of Health Sciences, University of Southampton, UK.
J Tissue Viability. 2024 Nov;33(4):992-998. doi: 10.1016/j.jtv.2024.08.004. Epub 2024 Aug 23.
Pressure-ulcer occurrence in the seated patient is understudied. Preventative devices have been developed and are prescribed commonly, but there is little quantitative evidence of their effectiveness. This study explores the concept of a lateral pressure device, a prevention device that applies pressure to the sides of the seated buttocks, to reduce the amount of tissue distortion and blood-vessel occlusion. It is hypothesized that this device will reduce deep tissue injury by reducing the pressure at the bone-muscle interface, as demonstrated computationally in previous research. This study aimed to use oximetry to investigate the efficacy of the device in maintaining transcutaneous gas tensions of the tissue as close to baseline as possible.
Oximetry electrodes were attached to participants' ischial tuberosity and greater trochanter for different amounts of lateral pressure. The amount of lateral pressure is a given percentage of the pressure due to the participants' underbody pressure.
The results show that 50 % lateral pressure is sufficient to produce an improvement in participants' gas tensions at their ischial tuberosity, without negatively impacting the tissue at their greater trochanter, relative to the control of sitting with no application of lateral pressure.
Despite a rudimentary prototype device design, and that participants each placed their own oximetry sensors, results support the application of lateral pressure as a method to maintain transcutaneous gas tensions. Further work should be carried out on a larger sample to consolidate these findings.
对于坐姿患者发生压疮的情况研究不足。预防性装置已被研发并广泛应用，但关于其有效性的定量证据很少。本研究探讨了一种侧向压力装置的概念，该装置通过对坐姿时臀部两侧施加压力，以减少组织变形和血管阻塞。假设该装置将通过降低骨 - 肌肉界面处的压力来减少深部组织损伤，正如先前研究所证明的那样。本研究旨在使用血氧测定法来研究该装置在尽可能使组织的经皮气体张力维持在接近基线水平方面的功效。
将血氧测定电极连接到参与者的坐骨结节和大转子上，施加不同量的侧向压力。侧向压力的量是参与者身体下方压力所产生压力的给定百分比。
结果表明，相对于不施加侧向压力的坐姿对照组，50%的侧向压力足以使参与者坐骨结节处的气体张力得到改善，且不会对其大转子处的组织产生负面影响。
尽管该装置的原型设计较为简陋，且参与者自行放置血氧测定传感器，但结果支持将侧向压力作为维持经皮气体张力的一种方法。应在更大样本上开展进一步研究以巩固这些发现。
