Abstract
Pressure ulcers are a common injury of the skin which leads to pain and potential infection for patients and financial burden to the healthcare providers across the global due to treatment costs, litigation and extended hospital stays. The current study focuses on one of the causes of pressure ulcer formation, ischemia. Blood vessels are deemed to be deformed and blood flow restricted when skin is subjected to external mechanical loads including friction, pressure and the combination of both. Hence, normal oxygen delivery to cells or metabolic waste removal are locally stopped which causes cells deaths and ultimately pressure ulcers.The current study proposes a 3D finite element analysis model which is capable of demonstrating the effect of friction, pressure and the combination of both to the deformation of blood vessels. The results of simulation suggested that applied pressure collapsed the blood vessels while friction opened up the blood vessels. However, as a combination effect of pressure and friction, the cross-sectional areas of blood vessels were reduced significantly. This model is clinically and physiologically relevant in terms of loading regime and blood vessels structures. The model with further development can be adopted to be an effective tool to evaluate the effects of medical devices to the possibility of pressure ulcer formation.
Highlights
The aim of the study is to develop a Finite element analysis (FEA) model to predict the effect of friction and pressure on skin in relation to pressure ulcer (PU) formation
It is proposed that this model with further development could be used to predict the effects of medical devices on the change in blood vessel dimensions whilst indicating the probability of pressure Ulcers (PU) formation
An increasing trend of PU formation is a financial burden to the healthcare systems across the globe
Summary
The stratum corneum, epidermis, dermis and hypodermis/ subcutaneous fat are the key layers of the skin Fig. 1 Each of these layers is unique, with different mechanical properties and varying distribution and configuration of blood vessels. This versatile organ can be subjected to various injuries and trauma, one severe instance which causes loss of integrity in the skin as a barrier to bacteria and infection is pressure Ulcers (PU) and friction blister formation. PU can be fatal and life-threatening in some cases where cellulitis, blood poisoning, bone and joint infection, necrotising fasciitis and gas gangrene developed as a result of PU formation [20] All these are the possible consequences of untreated stage 3 or 4 pressure ulcers
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