Dressings cut to shape alleviate facial tissue loads while using an oxygen mask

Abstract

Non‐invasive ventilation (NIV) masks are commonly used for respiratory support where intubation or a surgical procedure can be avoided. However, prolonged use of NIV masks involves risk to facial tissues, which are subjected to sustained deformations caused by tightening of the mask and microclimate conditions. The risk of developing such medical device‐related pressure ulcers can be reduced by providing additional cushioning at the mask‐face interface. In this work, we determined differences in facial tissue stresses while using an NIV mask with versus without using dressing cuts (Mepilex Lite; Mölnlycke Health Care, Gothenburg, Sweden). First, we developed a force measurement system that was used to experimentally determine local forces applied to skin at the bridge of the nose, cheeks, and chin in a healthy sample group while using a NIV mask. We further demonstrated facial temperature distributions after use of the mask using infrared thermography. Next, using the finite element method, we delivered the measured compressive forces per site of the face in the model and compared maximal effective stresses in facial tissues with versus without the dressing cuts. The dressings have shown substantial biomechanical effectiveness in alleviating facial tissues deformations and stresses by providing localised cushioning to the tissues at risk.

Which endotracheal tube location minimises the device‐related pressure ulcer risk: The centre or a corner of the mouth?

“…Their study, which included both experimental measurements and computational modelling, also resulted stress values that were under 7 kPa, similarly to our presently reported maximal shear stress values applied by ETTs . Furthermore, our resultant difference in tissue stress states is also in agreement with the above published work concerning facial tissue stresses under oxygen masks, in terms of the stress intensity ranges. Nevertheless, it should be considered that in real‐world conditions, PU risk profiles of patients requiring intubation vary remarkably.…”

“…Peko Cohen et al previously investigated the interactions between non‐invasive ventilation masks and facial soft tissues. Their study, which included both experimental measurements and computational modelling, also resulted stress values that were under 7 kPa, similarly to our presently reported maximal shear stress values applied by ETTs .…”

“…Peko Cohen et al previously investigated the interactions between non‐invasive ventilation masks and facial soft tissues. Their study, which included both experimental measurements and computational modelling, also resulted stress values that were under 7 kPa, similarly to our presently reported maximal shear stress values applied by ETTs . Furthermore, our resultant difference in tissue stress states is also in agreement with the above published work concerning facial tissue stresses under oxygen masks, in terms of the stress intensity ranges.…”

“…In each model variant, the effective and maximal shear stresses in the lips, mucosal tissues, and facial skin were calculated and compared, separately for each tissue type. Additionally, volumetric exposures of these parameters were plotted and compared across the two model variants, as per our published methodology to quantify device‐tissue interactions in the context of PUs and MDRPUs in particular . In order to allow systematic comparison between the model variants, all data analyses were performed for the soft tissues elements near the ETT segment with effective stress values greater than 3 kPa, which has been set as the threshold for defining the size of the volume of interest (VOI) (Figure ).…”

Modelling an adult human head on a donut‐shaped gel head support for pressure ulcer prevention

“…All elements were of the tetrahedral type; the numbers of elements in each model component are specified in Table . The FE simulations were set up using Preview (version 1.19, University of Utah, Salt Lake City, Utah), solved using the Pardiso FE solver (version 2.5) and post‐processed using PostView (version 1.9.1), which are all modules of the FEBio software package (University of Utah, Salt Lake City, Utah) . The runtime of each simulation was approximately 17 hours using a 64‐bit Windows 10 Pro‐based workstation with a CPU comprising Intel Xeon E5‐2620 2 GHz (two processors) and 64 GB RAM.…”