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The effects of deformation, ischemia, and reperfusion on the development of muscle damage during prolonged loading

The effects of deformation, ischemia, and reperfusion on the development of muscle damage during prolonged loading
The effects of deformation, ischemia, and reperfusion on the development of muscle damage during prolonged loading
Deep tissue injury (DTI) is a severe form of pressure ulcer where tissue damage starts in deep tissues underneath intact skin. In the present study, the contributions of deformation, ischemia, and reperfusion to skeletal muscle damage development were examined in a rat model during a 6-h period. Magnetic resonance imaging (MRI) was used to study perfusion (contrast-enhanced MRI) and tissue integrity (T2-weighted MRI). The levels of tissue deformation were estimated using finite element models. Complete ischemia caused a gradual homogeneous increase in T2 (?20% during the 6-h period). The effect of reperfusion on T2 was highly variable, depending on the anatomical location. In experiments involving deformation, inevitably associated with partial ischemia, a variable T2 increase (17–66% during the 6-h period) was observed reflecting the significant variation in deformation (with two-dimensional strain energies of 0.60–1.51 J/mm) and ischemia (50.8–99.8% of the leg) between experiments. These results imply that deformation, ischemia, and reperfusion all contribute to the damage process during prolonged loading, although their importance varies with time. The critical deformation threshold and period of ischemia that cause muscle damage will certainly vary between individuals. These variations are related to intrinsic factors, such as pathological state, which partly explain the individual susceptibility to the development of DTI and highlight the need for regular assessments of individual subjects.
pressure ulcers, skeletal muscle, magnetic resonance imaging, finite element modeling
8750-7587
1168-1177
Loerakker, S.
129b8e14-e50a-4858-ae3d-5b2eeac4448f
Manders, E.
3b5beab1-4531-4420-89c8-7cfc43ce497c
Strijkers, G.J.
59801515-c582-4f1a-a46b-055f1bc5122b
Nicolay, K.
c55ab2c0-0ba1-49ef-a554-ff3e42e891dc
Baaijens, F.P.
d930c09b-08ac-432f-8c3a-0e51619e9cdc
Oomens, C.W.J.
a8310c52-8ab4-4652-b2d6-82269a3c7438
Bader, D.L.
9884d4f6-2607-4d48-bf0c-62bdcc0d1dbf
Loerakker, S.
129b8e14-e50a-4858-ae3d-5b2eeac4448f
Manders, E.
3b5beab1-4531-4420-89c8-7cfc43ce497c
Strijkers, G.J.
59801515-c582-4f1a-a46b-055f1bc5122b
Nicolay, K.
c55ab2c0-0ba1-49ef-a554-ff3e42e891dc
Baaijens, F.P.
d930c09b-08ac-432f-8c3a-0e51619e9cdc
Oomens, C.W.J.
a8310c52-8ab4-4652-b2d6-82269a3c7438
Bader, D.L.
9884d4f6-2607-4d48-bf0c-62bdcc0d1dbf

Loerakker, S., Manders, E., Strijkers, G.J., Nicolay, K., Baaijens, F.P., Oomens, C.W.J. and Bader, D.L. (2011) The effects of deformation, ischemia, and reperfusion on the development of muscle damage during prolonged loading. Journal of Applied Physiology, 111 (4), 1168-1177. (doi:10.1152/japplphysiol.00389.2011). (PMID:21757578)

Record type: Article

Abstract

Deep tissue injury (DTI) is a severe form of pressure ulcer where tissue damage starts in deep tissues underneath intact skin. In the present study, the contributions of deformation, ischemia, and reperfusion to skeletal muscle damage development were examined in a rat model during a 6-h period. Magnetic resonance imaging (MRI) was used to study perfusion (contrast-enhanced MRI) and tissue integrity (T2-weighted MRI). The levels of tissue deformation were estimated using finite element models. Complete ischemia caused a gradual homogeneous increase in T2 (?20% during the 6-h period). The effect of reperfusion on T2 was highly variable, depending on the anatomical location. In experiments involving deformation, inevitably associated with partial ischemia, a variable T2 increase (17–66% during the 6-h period) was observed reflecting the significant variation in deformation (with two-dimensional strain energies of 0.60–1.51 J/mm) and ischemia (50.8–99.8% of the leg) between experiments. These results imply that deformation, ischemia, and reperfusion all contribute to the damage process during prolonged loading, although their importance varies with time. The critical deformation threshold and period of ischemia that cause muscle damage will certainly vary between individuals. These variations are related to intrinsic factors, such as pathological state, which partly explain the individual susceptibility to the development of DTI and highlight the need for regular assessments of individual subjects.

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More information

Published date: 14 July 2011
Keywords: pressure ulcers, skeletal muscle, magnetic resonance imaging, finite element modeling
Organisations: Faculty of Health Sciences

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Local EPrints ID: 347046
URI: http://eprints.soton.ac.uk/id/eprint/347046
ISSN: 8750-7587
PURE UUID: 2fd5c009-303c-4e4c-8bb4-cad0017ae8f1
ORCID for D.L. Bader: ORCID iD orcid.org/0000-0002-1208-3507

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Date deposited: 04 Feb 2013 11:51
Last modified: 14 Mar 2024 12:45

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Contributors

Author: S. Loerakker
Author: E. Manders
Author: G.J. Strijkers
Author: K. Nicolay
Author: F.P. Baaijens
Author: C.W.J. Oomens
Author: D.L. Bader ORCID iD

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