The User-Friendliness of Protective Support Surfaces in Prevention of Pressure Sores

Conine, Tali A.; Choi, Alice; Lim, Remy

doi:10.1002/j.2048-7940.1989.tb01114.x

Cited by 8 publications

(5 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…13,[35][36][37][38] Conventional preventative interventions focus on reducing superficial pressure through the use of specialized wheelchair cushions 7,40 ; however, most wheelchair cushions provide static reduction of pressure. Moreover, the effectiveness of pressure reduction depends on the type of cushion used, degree of muscle atrophy, and geometry of the ischial tuberosities 13,35 among other factors.…”

Section: Introductionmentioning

confidence: 99%

Effects of Intermittent Electrical Stimulation on Superficial Pressure, Tissue Oxygenation, and Discomfort Levels for the Prevention of Deep Tissue Injury

et al. 2010

View full text Add to dashboard Cite

The overall goal of this project is to develop effective methods for the prevention of deep tissue injury (DTI). DTI is a severe type of pressure ulcer that originates at deep bone-muscle interfaces as a result of the prolonged compression of tissue. It afflicts individuals with reduced mobility and sensation, particularly those with spinal cord injury. We previously proposed using a novel electrical stimulation paradigm called intermittent electrical stimulation (IES) for the prophylactic prevention of DTI. IES-induced contractions mimic the natural repositioning performed by intact individuals, who subconsciously reposition themselves as a result of discomfort due to prolonged sitting. In this study, we investigated the effectiveness of various IES paradigms in reducing pressure around the ischial tuberosities, increasing tissue oxygenation throughout the gluteus muscles, and reducing sitting discomfort in able-bodied volunteers. The results were compared to the effects of voluntary muscle contractions and conventional pressure relief maneuvers (wheelchair push-ups). IES significantly reduced pressure around the tuberosities, produced significant and long-lasting elevations in tissue oxygenation, and significantly reduced discomfort produced by prolonged sitting. IES performed as well or better than both voluntary contractions and chair push-ups. The results suggest that IES may be an effective means for the prevention of DTI.

show abstract

Section: Introductionmentioning

confidence: 99%

Effects of Intermittent Electrical Stimulation on Superficial Pressure, Tissue Oxygenation, and Discomfort Levels for the Prevention of Deep Tissue Injury

et al. 2010

View full text Add to dashboard Cite

show abstract

“…Current pressure ulcer prevention methods involve the use of pressure-reducing surfaces and weight-shifting paradigms. Despite substantial improvements in these approaches over the years, the incidence of pressure ulcers has not been effectively reduced (11,20,21,30,46,51,54,63). Moreover, conventional prevention methods have focused on reducing pressure at the seating surface; however, the prevention of DTI requires frequent redistribution of pressure and soft tissue deformation at the bone-muscle interface.…”

mentioning

confidence: 99%

Intermittent electrical stimulation redistributes pressure and promotes tissue oxygenation in loaded muscles of individuals with spinal cord injury

Gyawali

Solis²,

Chong

et al. 2011

Journal of Applied Physiology

View full text Add to dashboard Cite

Deep tissue injury (DTI) is a severe form of pressure ulcer that originates at the bone-muscle interface. It results from mechanical damage and ischemic injury due to unrelieved pressure. Currently, there are no established clinical methods to detect the formation of DTI. Moreover, despite the many recommended methods for preventing pressure ulcers, none so far has significantly reduced the incidence of DTI. The goal of this study was to assess the effectiveness of a new electrical stimulation-based intervention, termed intermittent electrical stimulation (IES), in ameliorating the factors leading to DTI in individuals with compromised mobility and sensation. Specifically, we sought to determine whether IES-induced contractions in the gluteal muscles can 1) reduce pressure in tissue surrounding bony prominences susceptible to the development of DTI and 2) increase oxygenation in deep tissue. Experiments were conducted in individuals with spinal cord injury, and two paradigms of IES were utilized to induce contractions in the gluteus maximus muscles of the seated participants. Changes in surface pressure around the ischial tuberosities were assessed using a pressure-sensing mattress, and changes in deep tissue oxygenation were indirectly assessed using T₂*-weighted magnetic resonance imaging (MRI) techniques. Both IES paradigms significantly reduced pressure around the bony prominences in the buttocks by an average of 10-26% (P < 0.05). Furthermore, both IES paradigms induced significant increases in T₂* signal intensity (SI), indicating significant increases in tissue oxygenation, which were sustained for the duration of each 10-min trial (P < 0.05). Maximal increases in SI ranged from 2-3.3% (arbitrary units). Direct measurements of oxygenation in adult rats revealed that IES produces up to a 100% increase in tissue oxygenation. The results suggest that IES directly targets factors contributing to the development of DTI in people with reduced mobility and sensation and may therefore be an effective method for the prevention of deep pressure ulcers.

show abstract

“…At the present time, techniques employed to prevent ulcer formation include frequent repositioning (12) as well as the use of specialized cushions and mattresses that provide either static or dynamic pressure relief of the tissues at risk (22,46). Recognizing the absence of a significant reduction in the incidence of pressure ulcers (10,15,16,30,42,49,50,54), new preventative interventions are needed, especially for DTI.…”

mentioning

confidence: 99%

Prevention of pressure-induced deep tissue injury using intermittent electrical stimulation

Solis

Hallihan²,

Uwiera³

et al. 2007

Journal of Applied Physiology

View full text Add to dashboard Cite

Pressure ulcers develop due to morphological and biochemical changes triggered by the combined effects of mechanical deformation, ischemia, and reperfusion that occur during extended periods of immobility. The goal of this study was to test the effectiveness of a novel electrical stimulation technique in the prevention of deep tissue injury (DTI). We propose that contractions elicited by intermittent electrical stimulation (IES) in muscles subjected to constant pressure would induce periodic relief in internal pressure; additionally, each contraction would also restore blood flow to the tissue. The application of constant pressure to the quadriceps muscles of rats generated a DTI that affected 60 +/- 15% of the compressed muscle as assessed by magnetic resonance imaging. In contrast, in the groups of rats that received IES at 10- and 5-min intervals, DTI of the muscle was limited to 16 +/- 16 and 25 +/- 13%, respectively. Injury to the muscle was corroborated by histology. In an experiment with a human volunteer, compression of the buttocks reduced the oxygenation level of the muscles by approximately 4%; after IES, oxygenation levels increased by approximately 6% beyond baseline. Concurrently, the surface pressure profiles of the loaded muscles were redistributed and the high-pressure points were reduced during each IES-induced contraction. The results of this study indicate that IES significantly reduces the amount of DTI by increasing the oxygen available to the tissue and by modifying the pressure profiles of the loaded muscles. This presents a promising technique for the prevention of pressure ulcers in immobilized and/or insensate individuals.

show abstract

The User-Friendliness of Protective Support Surfaces in Prevention of Pressure Sores

Cited by 8 publications

References 5 publications

Effects of Intermittent Electrical Stimulation on Superficial Pressure, Tissue Oxygenation, and Discomfort Levels for the Prevention of Deep Tissue Injury

Effects of Intermittent Electrical Stimulation on Superficial Pressure, Tissue Oxygenation, and Discomfort Levels for the Prevention of Deep Tissue Injury

Intermittent electrical stimulation redistributes pressure and promotes tissue oxygenation in loaded muscles of individuals with spinal cord injury

Prevention of pressure-induced deep tissue injury using intermittent electrical stimulation

Contact Info

Product

Resources

About