Biomechanical modelling of diabetic foot ulcers: A computational study

Singh, Gurpreet; Gupta, Shubham; Chanda, Arnab

doi:10.1016/j.jbiomech.2021.110699

Cited by 31 publications

(21 citation statements)

References 32 publications

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“…While the regions surrounding the incisions for all the skin graft models were meshed with quadratic elements, the remaining regions were meshed using linear elements of lower order. This was in line with several previous works employing tetrahedral elements for studying the deformation of intricate human soft tissue models and their comparison with clinical observations 38–41 . Optimal computational meshes were generated using the hybrid combination of quadratic and linear elements with element sizes ranging from 0.4 to 1 mm depending upon the skin graft model, and number of elements above 10,000.A detailed mesh convergence study was conducted with six different meshes for each skin graft model.…”

Section: Methodsmentioning

confidence: 64%

“…8 A few limitations of this work should be acknowledged. We considered the skin as an isotropic and elastic material model in line with previous literature works, 34,39,41 and to focus primarily on studying the effect of auxetic graft patterns on two-layer skin. In real, the skin consists of several layers of fibers, follicles, vessels, fat, etc.…”

Section: Discussionmentioning

confidence: 99%

“…This was in line with several previous works employing tetrahedral elements for studying the deformation of intricate human soft tissue models and their comparison with clinical observations. [38][39][40][41] Optimal computational meshes were generated using the hybrid combination of quadratic and linear elements with element sizes ranging from 0.4 to 1 mm depending upon the skin graft model, and number of elements above 10,000.A detailed mesh convergence study was conducted with six different meshes for each skin graft model. Three deformation values corresponding to 50%, 100%, and 200% strains were applied to each mesh and the mesh which the minimum variations in results (i.e., maximum stress within 5%) with further increase in the number of elements, was selected as the optimal mesh for any particular graft model.…”

Section: Finite Element Modelingmentioning

confidence: 99%

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Biomechanical modeling of novel high expansion auxetic skin grafts

Gupta¹,

Gupta²,

Chanda

2022

Numer Methods Biomed Eng

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Over 20 million burn injuries are reported every year, with severe cases requiring skin grafting. Traditionally, split thickness skin grafts are prepared by excising a small portion of healthy skin and its incision patterning using a suitable meshing device, which allows the graft to be expanded beyond its capacity. To date, the maximum expansion achieved through skin grafting has been reported to be less than three times, which is not sufficient for covering large burn sites with limited donor site skin. In this work, we have attempted to study skin graft expansion potential with novel auxetic patterns, which are known to exhibit negative Poisson's effect. Two‐layer skin graft models were developed using eight different auxetic incision patterns, and subjected to uniaxial and biaxial tensile strains. The Poisson's ratio, meshing ratio, and induced stresses were characterized for all graft models. The numerical results indicated expansion potentials greater than that of traditional skin grafts across all loads. Extremely high expansions (i.e., >30 times) were estimated for the I‐Shaped Re‐entrant and Rotating Triangles shaped auxetic models without rupture. Such pioneering findings are anticipated to initiate ground‐breaking advances towards skin graft research and improved outcomes in burn surgeries.

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Section: Methodsmentioning

confidence: 64%

Section: Discussionmentioning

confidence: 99%

Section: Finite Element Modelingmentioning

confidence: 99%

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Biomechanical modeling of novel high expansion auxetic skin grafts

Gupta¹,

Gupta²,

Chanda

2022

Numer Methods Biomed Eng

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“…Previous studies have documented the positive effects of PA on plantar pressure. Typically, maximal plantar pressure reduces in the heel area, midfoot, lateral plantar area, forefoot and central plantar area, where functional changes in the musculature are the most probable causes ( 9 ). In view of these considerations, we set about devising a simple yet functional programme focused on improving muscle strength.…”

Section: Discussionmentioning

confidence: 99%

“…Early prevention, which consists of diabetes control and inducing biomechanical changes in static (detected while standing) ( 9 ) and dynamic characteristics (gait abnormalities) ( 10 ), can reduce the risk of DFS, DFU and their recurrence. This could be achieved by controlled, structured physical activity (PA).…”

Section: Introductionmentioning

confidence: 99%

Effects of a 12-Week Interventional Exercise Programme on Muscle Strength, Mobility and Fitness in Patients With Diabetic Foot in Remission: Results From BIONEDIAN Randomised Controlled Trial

et al. 2022

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ObjectivesDiabetic foot syndrome (DFS) is a serious late diabetic complication characterised by limited joint mobility and other biomechanical and muscle abnormalities.AimTo evaluate the effect of an interventional exercise programme on anthropometric parameters, muscle strength, mobility and fitness in patients with diabetic foot in remission.Data Sources and Study SelectionThirty-eight patients with type 2 diabetes and DFS without active lesions (mean age 65 ± 6.9 years, BMI 32 ± 4.7 kg.m-2, waist-hip ratio (WHR)1.02 ± 0.06) were enrolled in our randomised controlled trial. All subjects were randomised into two groups: an intervention group (I; n=19) and a control group (C; n=19). The 12-week exercise intervention focused on ankle and small-joint mobility in the foot, strengthening and stretching of the lower extremity muscles, and improvements in fitness. Changes (Δ=final minus initial results) in physical activity were assessed using the International Physical Activity Questionnaire (IPAQ), with joint mobility detected by goniometry, muscle strength by dynamometry, and fitness using the Senior Fitness Test (SFT).Data extractionDue to reulceration, 15.8% of patients from group I (3/19) and 15.8% of patients from group C were excluded. Based on the IPAQ, group I was more active when it came to heavy (p=0.03) and moderate physical activity (p=0.06) after intervention compared to group C. Group I improved significantly in larger-joint flexibility (p=0.012) compared to controls. In group I, dynamometric parameters increased significantly in both lower limbs (left leg; p=0.013, right leg; p=0.043) compared to group C. We observed a positive trend in the improvement of fitness in group I compared to group C. We also confirmed positive correlations between heavy physical activity and selected parameters of flexibility (r=0.47; p=0.007), SFT (r=0.453; p=0.011) and dynamometry (r=0.58; p<0.0025). Anthropometric parameters, such as BMI and WHR, were not significantly influenced by the intervention programme.ConclusionOur 12-week interventional exercise programme proved relatively safe, resulting in improved body flexibility and increased muscle strength in DF patients in remission.

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3D Printing Applications in Orthotic Insoles: Asymptomatic, Diabetic and Sports Users

Shaikh

2024

Biomedical Materials for Multi-Functional Applications

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Biomechanical modelling of diabetic foot ulcers: A computational study

Cited by 31 publications

References 32 publications

Biomechanical modeling of novel high expansion auxetic skin grafts

Biomechanical modeling of novel high expansion auxetic skin grafts

Effects of a 12-Week Interventional Exercise Programme on Muscle Strength, Mobility and Fitness in Patients With Diabetic Foot in Remission: Results From BIONEDIAN Randomised Controlled Trial

3D Printing Applications in Orthotic Insoles: Asymptomatic, Diabetic and Sports Users

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