Ischemia‐reperfusion injury in chronic pressure ulcer formation: A skin model in the rat

Peirce, Shayn M.; Skalak, Thomas C.; Rodeheaver, George T.

doi:10.1046/j.1524-475x.2000.00068.x

Cited by 259 publications

(175 citation statements)

References 11 publications

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“…3), we observed that relieving the pressure initially resulted in increased perfusion (reactive hyperaemia) 4,29 as the blood returned to the affected tissue. When blood returns to the ischaemic tissue, it produces reactive oxygen species and free radicals that can accelerate cell death 30,31 . In our model, 1 h of pressure produced mild reversible tissue damage, and 3 h of pressure produced more severe irreversible damage.…”

Section: Resultsmentioning

confidence: 99%

Impedance sensing device enables early detection of pressure ulcers in vivo

et al. 2015

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When pressure is applied to a localized area of the body for an extended time, the resulting loss of blood flow and subsequent reperfusion to the tissue causes cell death and a pressure ulcer develops. Preventing pressure ulcers is challenging because the combination of pressure and time that results in tissue damage varies widely between patients, and the underlying damage is often severe by the time a surface wound becomes visible. Currently, no method exists to detect early tissue damage and enable intervention. Here we demonstrate a flexible, electronic device that non-invasively maps pressure-induced tissue damage, even when such damage cannot be visually observed. Using impedance spectroscopy across flexible electrode arrays in vivo on a rat model, we find that impedance is robustly correlated with tissue health across multiple animals and wound types. Our results demonstrate the feasibility of an automated, non-invasive 'smart bandage' for early detection of pressure ulcers.

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Section: Resultsmentioning

confidence: 99%

Impedance sensing device enables early detection of pressure ulcers in vivo

et al. 2015

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“…Other theories for the onset of tissue damage include collapse of capillaries and lymph nodes [29][30][31], reperfusion injury [32][33][34], and cell deformation under pressure [5,33,35]. The last has been studied using finite element (FE) models with a damage threshold law derived from previous experiments [4,36].…”

Section: Introductionmentioning

confidence: 99%

Toward real-time detection of deep tissue injury risk in wheelchair users using Hertz contact theory

Agam

Gefen²

2008

JRRD

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Abstract-This study assessed the suitability of a new portable system that is based on Hertz's contact theory for evaluating internal gluteal muscle stresses under the ischial tuberosities of wheelchair users in real-time as a risk indicator for a deep tissue injury. Sitting in a wheelchair was monitored and processed with the portable system for six control subjects and five individuals with paraplegia. We compared the resultant internal peak and average muscle stresses and stress integrals over time (stress doses) of the control subjects with those of the subjects with paraplegia and validated the results against previously published subject-specific finite element (FE) stress data for the same subjects. Individuals with paraplegia were characterized by peak muscle compression stresses (mean +/-standard deviation = 109 +/-41 kPa) that were 2.4-fold higher than in control subjects (p < 0.03). A Bland-Altman comparison indicated that stresses recorded by the present system were in satisfactory agreement with previous subject-specific magnetic resonance imaging-FE analyses. We conclude that the present stress monitoring system has the potential to be a practical means for evaluating internal muscle stresses during everyday life of individuals with paraplegia.

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“…Reperfusion of blood to nutrientand oxygen-deprived tissue results in injury distinct from that caused by ischemic insult alone and has been implicated in distinct mechanisms of tissue injury that contribute to inflammation, vascular insufficiency, and ulcer formation [35]. Clinical evidence of reactive hyperemia in people with lower-limb amputation from prosthesis use dates back to 1962 [36].…”

Section: Discussionmentioning

confidence: 99%

Elevated vacuum suspension preserves residual-limb skin health in people with lower-limb amputation: Randomized clinical trial

et al. 2016

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Abstract-A growing number of clinical trials and case reports support qualitative claims that use of an elevated vacuum suspension (EVS) prosthesis improves residual-limb health on the basis of self-reported questionnaires, clinical outcomes scales, and wound closure studies. Here, we report first efforts to quantitatively assess residual-limb circulation in response to EVS. Residual-limb skin health and perfusion of people with lower-limb amputation (N = 10) were assessed during a randomized crossover study comparing EVS with nonelevated vacuum suspension (control) over a 32 wk period using noninvasive probes (transepidermal water loss, laser speckle imaging, transcutaneous oxygen measurement) and functional hyperspectral imaging approaches. Regardless of the suspension system, prosthesis donning decreased perfusion in the residual limb under resting conditions. After 16 wk of use, EVS improved residual-limb oxygenation during treadmill walking. Likewise, prosthesis-induced reactive hyperemia was attenuated with EVS following 16 wk of use. Skin barrier function was preserved with EVS but disrupted after control socket use. Taken together, outcomes suggest chronic EVS use improves perfusion and preserves skin barrier function in people with lower-limb amputation.Clinical Trial Registration: ClinicalTrials.gov; "Evaluation of limb health associated with a prosthetic vacuum socket system": NCT01839123; https://clinicaltrials.gov/ct2/show/ NCT01839123?term=NCT01839123&rank=1

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Ischemia‐reperfusion injury in chronic pressure ulcer formation: A skin model in the rat

Cited by 259 publications

References 11 publications

Impedance sensing device enables early detection of pressure ulcers in vivo

Impedance sensing device enables early detection of pressure ulcers in vivo

Toward real-time detection of deep tissue injury risk in wheelchair users using Hertz contact theory

Elevated vacuum suspension preserves residual-limb skin health in people with lower-limb amputation: Randomized clinical trial

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