12 - Neuroprostheses to restore or improve tissue health: Insights from prevention of deep pressure ulcers

Abstract

Pressure ulcers are common. Of these ulcers, deep tissue injury is particularly perilous because it does not become apparent until advanced stages. Conventional passive options such as pressure mattresses and periodical turning have not been sufficient to reduce the incidence of pressure ulcers. Therefore, a fundamentally different innovative strategy is needed. We tested the effects of intermittent electrical stimulation on the restoration of oxygenation, relief of mechanical deformation, and prevention of tissue necrosis in animal models and in patients at high risk of deep tissue injury. To test the clinical feasibility and safety of this novel treatment, we designed a delivery system and applied it to patients in a wide variety of clinical settings. It was found to be feasible and safe. Indeed, many patients continued to use the neuroprosthesis well beyond the initial study period, with no observed incidence of pressure ulcer. Further study is needed to test the efficacy of intermittent electrical stimulation on deep pressure ulcer prevention.