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Effects of Biowastes Released by Mechanically Damaged Muscle Cells on the Propagation of Deep Tissue Injury: A Multiphysics Study

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Abstract

Deep tissue injuries occur in muscle tissues around bony prominences under mechanical loading leading to severe pressure ulcers. Tissue compression can potentially compromise lymphatic transport and cause accumulation of metabolic biowastes, which may cause further cell damage under continuous mechanical loading. In this study, we hypothesized that biowastes released by mechanically damaged muscle cells could be toxic to the surrounding muscle cells and could compromise the capability of the surrounding muscle cells to withstand further mechanical loadings. In vitro, we applied prolonged low compressive stress (PLCS) and short-term high compressive stress to myoblasts to cause cell damage and collected the biowastes released by the damaged cells under the respective loading scenarios. In silico, we used COMSOL to simulate the compressive stress distribution and the diffusion of biowastes in a semi-3D buttock finite element model. In vitro results showed that biowastes collected from cells damaged under PLCS were more toxic and could compromise the capability of normal myoblasts to resist compressive damage. In silico results showed that higher biowastes diffusion coefficient, higher biowastes release rate, lower biowastes tolerance threshold and earlier timeline of releasing biowastes would cause faster propagation of tissue damage. This study highlighted the importance of biowastes in the development of deep tissue injury to clinical pressure ulcers under prolonged skeletal compression.

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Acknowledgments

This study was supported by Hong Kong Research Grant Council (RGC Ref. No.: CUHK415413).

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Authors and Affiliations

  1. Division of Biomedical Engineering, The Chinese University of Hong Kong, Hong Kong SAR, China

    Yifei Yao, Lucas Xian Da Ong, Xiaotong Li, Kinlun Wan & Arthur F. T. Mak

  2. Department of Biomedical Engineering, National University of Singapore, Singapore, Singapore

    Lucas Xian Da Ong

  3. Division of Biomedical Engineering, The Chinese University of Hong Kong, Rm. 429, Ho Sin Hang Engineering Building, Shatin, N.T., Hong Kong SAR, China

    Arthur F. T. Mak

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  1. Yifei Yao
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Correspondence to Arthur F. T. Mak.

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Associate Editor Karol Miller oversaw the review of this article.

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Yao, Y., Da Ong, L.X., Li, X. et al. Effects of Biowastes Released by Mechanically Damaged Muscle Cells on the Propagation of Deep Tissue Injury: A Multiphysics Study. Ann Biomed Eng 45, 761–774 (2017). https://doi.org/10.1007/s10439-016-1731-2

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