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Deep tissue injury: how deep is our understanding?

Deep tissue injury: how deep is our understanding?
Deep tissue injury: how deep is our understanding?
Deep pressure ulcers, necessarily involving deep tissue injury (DTI), arise in the muscle layers adjacent to bony prominences because of sustained loading. They represent a serious type of pressure ulcer because they start in underlying tissues and are often not visible until they reach an advanced stage, at which time treatment becomes problematic. Underlying mechanisms of DTI require further investigation if appropriate preventive measures are to be determined. The present commentary illustrates a hierarchic research approach selected to study these mechanisms. To differentiate between the individual roles of deformation and ischemia in the onset of skeletal muscle damage, 2 complementary approaches have been selected. In an in vivo animal model, the effects of ischemia combined with deformation and ischemia per se were studied. An in vitro muscle model was used to study the separate effects of deformation and several aspects of ischemia, including hypoxia, glucose depletion, and tissue acidification, in more detail. Based on the results of both models a sequence of events leading to cell necrosis is proposed. Deformation levels exceeding a threshold value can result in rapid tissue damage that may persist, whereas ischemia has a more gradual effect as a result of glucose depletion and tissue acidification
pressure ulcer, rehabilitation
0003-9993
1410-1413
Stekelenburg, Anke
94463837-6ab4-48ad-b8ca-abaf27aa5dfd
Gawlitta, Debby
24893094-a770-486a-8ef9-723207a6c2e3
Bader, Dan L.
9884d4f6-2607-4d48-bf0c-62bdcc0d1dbf
Oomens, Cees W.
12b2046f-3a4e-4b14-b1d0-77d48333197a
Stekelenburg, Anke
94463837-6ab4-48ad-b8ca-abaf27aa5dfd
Gawlitta, Debby
24893094-a770-486a-8ef9-723207a6c2e3
Bader, Dan L.
9884d4f6-2607-4d48-bf0c-62bdcc0d1dbf
Oomens, Cees W.
12b2046f-3a4e-4b14-b1d0-77d48333197a

Stekelenburg, Anke, Gawlitta, Debby, Bader, Dan L. and Oomens, Cees W. (2008) Deep tissue injury: how deep is our understanding? Archives of Physical Medicine and Rehabilitation, 89 (7), 1410-1413. (doi:10.1016/j.apmr.2008.01.012). (PMID:18586145)

Record type: Article

Abstract

Deep pressure ulcers, necessarily involving deep tissue injury (DTI), arise in the muscle layers adjacent to bony prominences because of sustained loading. They represent a serious type of pressure ulcer because they start in underlying tissues and are often not visible until they reach an advanced stage, at which time treatment becomes problematic. Underlying mechanisms of DTI require further investigation if appropriate preventive measures are to be determined. The present commentary illustrates a hierarchic research approach selected to study these mechanisms. To differentiate between the individual roles of deformation and ischemia in the onset of skeletal muscle damage, 2 complementary approaches have been selected. In an in vivo animal model, the effects of ischemia combined with deformation and ischemia per se were studied. An in vitro muscle model was used to study the separate effects of deformation and several aspects of ischemia, including hypoxia, glucose depletion, and tissue acidification, in more detail. Based on the results of both models a sequence of events leading to cell necrosis is proposed. Deformation levels exceeding a threshold value can result in rapid tissue damage that may persist, whereas ischemia has a more gradual effect as a result of glucose depletion and tissue acidification

Full text not available from this repository.

More information

e-pub ahead of print date: 27 June 2008
Published date: July 2008
Keywords: pressure ulcer, rehabilitation
Organisations: Health Sciences

Identifiers

Local EPrints ID: 169051
URI: https://eprints.soton.ac.uk/id/eprint/169051
ISSN: 0003-9993
PURE UUID: 40881629-e2ed-4734-8ff2-56a25aecc247
ORCID for Dan L. Bader: ORCID iD orcid.org/0000-0002-1208-3507

Catalogue record

Date deposited: 09 Dec 2010 09:19
Last modified: 10 Dec 2019 01:38

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