Indentation tests and the prototype patient simulator trial demonstrated similar trends with high pressures closest to the bony prominence with decreasing magnitude toward the interfacial surface. Qualitatively, silicone mimicked the phenomenon observed in muscle of nonuniform stress under concentrated loading. Although shear moduli were within biological ranges, stress and stiffness values exceeded those of porcine muscle. This research represents a first step toward development of a preclinical model simulating the biomechanical conditions of stress and strain in deep muscle, since local biomechanical factors are acknowledged to play a role in DTI initiation. Future research is needed to refine the capacity of preclinical models to simulate biomechanical parameters in successive tissue layers of muscle, fat, dermis, and epidermis typically intervening between bone and support surfaces, for body regions at risk for DTI.
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