Abstract
The pressure injuries are a secondary complication of spinal cord injury. A strategy to prevent them is advancing support surfaces, like wheelchair cushions or mattress that redistributed the body weight avoiding high stresses in areas to prone to develop pressure injuries, like ischial tuberosities (ITs). To assess support surfaces, the superficial pressure (Interface Pressure) are measuring. These measurements do not guarantee that internal tissue underlying to bony prominences (ITs) do not experience high stresses, however measurements in internal tissue are prohibitive. The present study estimates stresses and strains in underlying tissue of ITs applying Finite Element Method (FEM). A CAD model of pelvis was built from tomographic slices of a pelvis copy of a male subject, with 70 kg of weight and 1.70 m of high. The model was exported to finite element software COMSOL. The simulation conditions were: the bone and soft tissues were assumed linear and isotropic; load 450 N simulated the body trunk, and six cases were analyzed: healthy tissues; pressure injuries in internal tissue underlying to ITs; pressure injuries that affect all soft tissue without included skin; pressure injuries that affect all soft tissue included skin; and pressure injuries that affect skin and part of soft tissue. Maximum stress points in all cases are located below ITs, this fact is according to literature. The stresses in healthy tissues are lower than sides with pressure injuries, and stresses and strains of internal pressure injuries are higher than stresses and strains of external pressure injuries. The tendency of strains are to increase while tissue density decreases, it means the greater tissue damage, the greater strains. In tissue with 25% of damage, strains were 1.02 higher than healthy tissue. In otherwise, stresses are greater in internal pressure injuries, this fact is not observed in external pressure injuries, and however the stress value is decreased while tissue damage is increased. This analysis can be applied to design customized support surface for subject with spinal cord injury.
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References
NPUAP.org. National Pressure Ulcer Advisory Panel. 2016 [cited 2017 Jun 29]. Available from: www.npuap.org.
Sen C, Gordillo G, Roy S, Kirnser R, Lambert L, Hunt T, et al. Human Skin Wounds: A major and snowballing threat to Public Health and Economy. Wound Repair Regen. 2009; 7(6):763–71.
Pérez-Zavala R, Rodríguez-Velazco E, Escobar-Rodríguez ÁD. Frecuencia de úlceras por presión en el paciente lesionado medular, su correlación con el nivel neurológico y escala de ASIA. Rev Mex Med Física y Rehabil. 2007; 19:16–23.
Bersgstrom N. Patients at risk for pressure ulcers and evidence-based care for pressure ulcer prevention. In: Bouter C, Bader DL, editors. Pressure Ulcer Researh Current and Future Perspective. Berlín: Spriger; 2005. p. 36–49.
SILAUHE. Declaracion De Río de Janeiro sobre la prevención de las úlceras por presión como derecho universal [cited 2017 Jun 29]. 2011. p. 1–4. Available from: http://silauhe.org/img/Declaracion/de/Rio-Espanol.pdf.
Xio DZ, Wu SY, Mak AF Accumulation of loading damage and unloading reperfusion injury-modeling of propagation of deep tissue ulcers. J. Biomech 2014; 47(7):1659–64.
Gefen A, Linder-Ganz E, Margulies SS. In vivo muscle stiffening under bone compression promotes deep pressure sores. J Biomech Eng. 2005; 127(3):512–24.
Lin F, Moran B, Bankard J, Hendrix R, Makhsous M. FEM model for evaluating buttock tissue response under sitting load. Conf Proc IEEE Eng. Med Biol Soc, 2014; 7:5088–91.
Majumder S, Roychowdhury A, Pal SA. Finite Element study of the behavior of human pelvis under impact through car door. Berichte der Bundesanstalt Fuer Strassenwesen. Unterreihe Fahrzeugtehcnin. 2005; 55: 196–203.
Matsuo J, Sugama J, Sanada H, Okuwa M, Nakatani T, Konya C, Sakamoto J. Development and validity of a new model for assessing pressure redistribution properties of suppor surfaces. J Tissue Viability. 2011; 20(2):55–66.
Gefen A and Levine J. The false premise in measuring bodu-support interface pressures for preventing serious pressure ulcers. J Med Eng Technol. 2007; 31(5):375–80.
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Gayol-Mérida, D.A. et al. (2018). Analysis of Mechanical Behavior of the Underlying Soft Tissue to Ischial Tuberosities Using Finite Element Method. In: Ambriz, R., Jaramillo, D., Plascencia, G., Nait Abdelaziz, M. (eds) Proceedings of the 17th International Conference on New Trends in Fatigue and Fracture. NT2F 2017. Springer, Cham. https://doi.org/10.1007/978-3-319-70365-7_8
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DOI: https://doi.org/10.1007/978-3-319-70365-7_8
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