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Compression-induced damage and internal tissue strains are related

Compression-induced damage and internal tissue strains are related
Compression-induced damage and internal tissue strains are related
Prolonged mechanical loading of soft tissues adjacent to bony prominences can lead to degeneration of muscle tissue, resulting in a condition termed pressure-related deep tissue injury. This type of deep pressure ulcers can develop into a severe wound, associated with problematic healing and a variable prognosis. Limited knowledge of the underlying damage pathways impedes effective preventive strategies and early detection. Traditionally, pressure-induced ischaemia has been thought to be the main aetiological factor for initiating damage. Recent research, however, proposes tissue deformation per se as another candidate for initiating pressure-induced deep tissue injury. In this study, different strain parameters were evaluated on their suitability as a generic predictive indicator for deep tissue injury. With a combined animal-experimental numerical approach, we show that there is a reproducible monotonic increase in damage with increasing maximum shear strain once a strain threshold has been exceeded. This relationship between maximum shear strain and damage seems to reflect an intrinsic muscle property, as it applied across a considerable number of the experiments. This finding confirms that tissue deformation per se is important in the aetiology of deep tissue injury. Using dedicated finite element modeling, a considerable reduction in the inherent biological variation was obtained, leading to the proposal that muscle deformation can prove a generic predictive indicator of damage.
deep tissue injury, pressure ulcers, deformation, aetiology
0021-9290
3399-3404
Ceelen, K.K.
3e9d84ab-1fa2-4b31-9883-c9076b001d68
Stekelenburg, A.
81bba22a-0eb4-48fa-9504-2faa5c174366
Loerakker, S.
129b8e14-e50a-4858-ae3d-5b2eeac4448f
Strijkers, G.J.
59801515-c582-4f1a-a46b-055f1bc5122b
Bader, D.L.
9884d4f6-2607-4d48-bf0c-62bdcc0d1dbf
Nicolay, K.
c55ab2c0-0ba1-49ef-a554-ff3e42e891dc
Baaijens, F.P.T.
5d9e63e2-7d7b-4f64-b942-29121121dce0
Oomens, C.W.J.
a8310c52-8ab4-4652-b2d6-82269a3c7438
Ceelen, K.K.
3e9d84ab-1fa2-4b31-9883-c9076b001d68
Stekelenburg, A.
81bba22a-0eb4-48fa-9504-2faa5c174366
Loerakker, S.
129b8e14-e50a-4858-ae3d-5b2eeac4448f
Strijkers, G.J.
59801515-c582-4f1a-a46b-055f1bc5122b
Bader, D.L.
9884d4f6-2607-4d48-bf0c-62bdcc0d1dbf
Nicolay, K.
c55ab2c0-0ba1-49ef-a554-ff3e42e891dc
Baaijens, F.P.T.
5d9e63e2-7d7b-4f64-b942-29121121dce0
Oomens, C.W.J.
a8310c52-8ab4-4652-b2d6-82269a3c7438

Ceelen, K.K., Stekelenburg, A., Loerakker, S., Strijkers, G.J., Bader, D.L., Nicolay, K., Baaijens, F.P.T. and Oomens, C.W.J. (2008) Compression-induced damage and internal tissue strains are related. Journal of Biomechanics, 41 (16), 3399-3404. (doi:10.1016/j.jbiomech.2008.09.016). (PMID:19010470)

Record type: Article

Abstract

Prolonged mechanical loading of soft tissues adjacent to bony prominences can lead to degeneration of muscle tissue, resulting in a condition termed pressure-related deep tissue injury. This type of deep pressure ulcers can develop into a severe wound, associated with problematic healing and a variable prognosis. Limited knowledge of the underlying damage pathways impedes effective preventive strategies and early detection. Traditionally, pressure-induced ischaemia has been thought to be the main aetiological factor for initiating damage. Recent research, however, proposes tissue deformation per se as another candidate for initiating pressure-induced deep tissue injury. In this study, different strain parameters were evaluated on their suitability as a generic predictive indicator for deep tissue injury. With a combined animal-experimental numerical approach, we show that there is a reproducible monotonic increase in damage with increasing maximum shear strain once a strain threshold has been exceeded. This relationship between maximum shear strain and damage seems to reflect an intrinsic muscle property, as it applied across a considerable number of the experiments. This finding confirms that tissue deformation per se is important in the aetiology of deep tissue injury. Using dedicated finite element modeling, a considerable reduction in the inherent biological variation was obtained, leading to the proposal that muscle deformation can prove a generic predictive indicator of damage.

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Published date: 5 December 2008
Keywords: deep tissue injury, pressure ulcers, deformation, aetiology
Organisations: Medicine

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Local EPrints ID: 169059
URI: https://eprints.soton.ac.uk/id/eprint/169059
ISSN: 0021-9290
PURE UUID: f5d34412-714a-4d00-a85d-1d6503d53034
ORCID for D.L. Bader: ORCID iD orcid.org/0000-0002-1208-3507

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Date deposited: 09 Dec 2010 09:35
Last modified: 05 Nov 2019 01:41

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Contributors

Author: K.K. Ceelen
Author: A. Stekelenburg
Author: S. Loerakker
Author: G.J. Strijkers
Author: D.L. Bader ORCID iD
Author: K. Nicolay
Author: F.P.T. Baaijens
Author: C.W.J. Oomens

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