|
|
Biomechanical Modeling and Experimental Study on the Common Sites of Pressure Ulcers inthe Process of Assisted Turning over from Supine Position |
Lun Qinglong1, Su Peng1*, Lu Da2, Li Shuo1, Li Jian3 |
1(School of Electromechanical Engineering, Beijing Information Science and Technology University, Beijing 100192, China) 2(School of Biological and Medical Engineering, Beihang University, Beijing 100191, China) 3(Key Laboratory of Rehabilitation Aids Technology and System of the Ministry of Civil Affairs, National Research Center for Rehabilitation Technical Aids, Beijing 100176, China) |
|
|
Abstract A pressure ulcer is a condition in which the long-term pressure on local tissues leads to tissue ulceration and necrosis. Relief of local pressure through supine lateral rotation is one of the effective measures to prevent the development of pressure ulcers in long-term bedridden patients, so it is significant to study the biomechanics of the typical site of pressure ulcers during assisted lateral rotation. Based on anatomical theory, a finite element model of the bones and soft tissues of the pressure ulcer-prone areas of the trunk was established using CT image data to study the maximum stresses on the pressure ulcer-prone areas of the trunk at different lateral turning angles, and a human supine lateral turning experiment was conducted on 10 volunteers using the TEKSCAN pressure distribution test system to verify the correctness of the simulation analysis. Results showed that the stresses on the same part of the body were different during the rollover process, with extreme points of stress peaks at 90° position, producing a stress concentration phenomenon. The peak stresses at each part of the shoulder and hip were relatively evenly balanced within the angular threshold range of 30° to 45°, both at 0.035~0.070 MPa, indicating that the body was in contact with multiple parts of the auxiliary surface within this threshold and that the stresses are more dispersed, with a form of contact between the two that optimized pressure on multiple pressure ulcer prone areas. This study demonstrated the changes in pressure on pressure-prone areas of the trunk during assisted supine lateral rotation, and the obtained results would be useful for the design and use of supine lateral rotation aids and as a reference for clinical care.
|
Received: 09 June 2021
|
|
Corresponding Authors:
*E-mail: supeng@bistu.edu.cn
|
|
|
|
[1] Haesler E. Prevention and treatment of pressure ulcers/injuries: Clinical Practice Guideline. The International Guideline [M]. Los Angeles: European Pressure Ulcer Advisory Panel, National Pressure Injury Advisory Panel and Pan Pacific Pressure Injury Alliance, 2019: 16-38. [2] 王彩凤,巫向前. 老年压疮相关因素的Logistic回归分析 [J]. 中国实用护理杂志, 2008, 24(26): 16-19. [3] 蒋琪霞,刘云,管晓萍,等. 住院患者压疮现患率的多中心研究 [J]. 医学研究生学报, 2013, 26(12) : 1298-1303. [4] McGinnis E, Briggs M, Collinson M, et al. Pressure ulcer related pain in community populations: a prevalence survey [J]. BMC Nurs, 2014, 13(16): 1-10. [5] Kumari S, Sharma D, Rana A, et al. Risk assessment tool for pressure ulcer development in Indian surgical wards [J]. Indian J Surg, 2015, 77(3): 206-212. [6] Bennett G. The cost of pressure ulcers in the UK [J]. Age &Aging, 2004, 33(3): 230-235. [7] Romanelli M, Clark M, Cherry G, et al. Science and Practice of Pressure Ulcer Management [M]. London: Springer, 2006: 129-137. [8] 刘杰,朱凌云,苟向锋. 多功能护理床发展现状与趋势 [J]. 医疗卫生装备, 2019, 40(7): 94-98,103. [9] Zhou Jin, Wu Jianxin, Liu Yaoxia, et al. Care of patient lying with varied supine angles: a quantitative pressure evaluation [J]. Leather and Footwear Journal, 2015, 15(2): 61-72. [10] Defloor T. The effect of position and mattress on interface pressure [J]. Appl Nurs Res, 2000, 13(1): 2-11. [11] Oomens CWJ, Broek M, Hemmes B, et al. How does lateral tilting affect the internal strains in the sacral region of bed ridden patients? -A contribution to pressure ulcer prevention [J]. Clin Biomech, 2016, 35: 7-13. [12] Gillespie BM, Chaboyer WP, McInnes E, et al. Repositioning for pressure ulcer prevention in adults [J]. Cochrane Database Syst Rev, 2014, 2014(4): CD009958. [13] 吴未艾,江曦,史琴芳,等. 两种侧卧体位在长期卧床老年患者压疮护理中的应用效果比较 [J]. 世界最新医学信息文摘(电子版), 2018(44): 257-258. [14] 从金霞. 术中改良体位护理对长时间侧卧位患者压疮形成的影响 [J]. 实用临床医药杂志, 2017, 21(10): 91-93,100. [15] 李素姣,王珏,宁文德,等. 人体臀部与个性化防压疮坐垫的有限元建模 [C] //第三届北京国际康复论坛论文集. 北京: 《中国康复理论与实践》编辑部, 2008: 587-590. [16] 卢达,苏鹏,季润,等. 人体仰卧位侧翻的动力学仿真及实验验证 [J]. 生物医学工程学杂志, 2019, 36(5): 777-784. [17] Wen W, Lee P, Bryant AL, et al. Subject-specific musculoskeletal modeling in the evaluation of shoulder muscle and joint function [J]. J Biomech, 2016, 49(15): 3626-3634. [18] Levy A, Kopplin K, Gefen A. Device-related pressure ulcers from a biomechanical perspective [J]. J Tissue Viability, 2017, 26(1): 57-68. [19] Boyle C, Kim IY. Comparison of different hip prosthesis shapes considering micro-level bone remodeling and stress-shielding criteria using three-dimensional design space topology optimization [J]. J Biomech, 2011, 44(9): 1722-1728. [20] Verver MM, Hoof JV, Oomens C, et al. A finite element model of the human buttocks for prediction of seat pressure distributions [J]. Comput Methods Biomech Biomed Engin, 2004, 7(4): 193-203. [21] Ahir SP, Walker PS, Squire-Taylor CJ, et al. Analysis of glenoid fixation for a reversed anatomy fixed-fulcrum shoulder replacement [J]. J Biomech, 2004, 37(11): 1699-1708. [22] Polikeit A, Nolte LP, Ferguson SJ. The effect of cement augmentation on the load transfer in an osteoporotic functional spinal unit: finite-element analysis [J]. Spine, 2003, 28(10): 991-996. [23] García JM, Doblaré M, Seral B, et al. Three-dimensional finite element analysis of several internal and external pelvis fixations [J]. J Biomech Eng, 2000, 122(5): 516-522. [24] Grujicic M, Pandurangan B, Arakere G, et al. Seat-cushion and soft-tissue material modeling and a finite element investigation of the seating comfort for passenger-vehicle occupants [J]. Mater Design, 2009, 30(10): 4273-4285. [25] 李桂红,唐娟. 不同翻身侧卧角度对ICU难免压疮发生率的影响 [J]. 当代护士, 2019, 26(2): 151-153. [26] 李简玲,邓敏娉,卢婉娴. 两种不同角度侧卧在ICU斜坡卧位患者中的应用及效果评价 [J]. 当代医学, 2017, 23(19): 190-191. [27] 王志燕,朱晓群,杨晶,等. 不同翻身角度对老年卧床患者皮肤受压及生命体征的影响 [J]. 护士进修杂志, 2009, 24(7): 581-583. [28] Zhou Qing, Rouhana SW, Melvin JW. Ageeffects on thoracic injury tolerance [J]. Sae Paper, 1996,105: 962421. [29] 李云婷,陶凯,王冬梅,等. 足底软组织硬化对足部生物力学性能影响的三维有限元分析 [J]. 医用生物力学, 2009, 24(3): 169-173. [30] Hsu Chih-Chin, Tsai Wen-Chung, Chen Carl Pai-Chu, et al. Effects of aging on the plantar soft tissue properties under the metatarsal heads at different impact velocities [J]. Ultrasound in Medicine & Biology, 2005, 31(10): 1423-1429. [31] Kwan Rachel Lai-Chu, Zheng Yong-Ping, Cheing Gladys Lai-Ying. The effect of aging on the biomechanical properties of plantar soft tissues [J]. Clin Biomech, 2010, 25(6): 601-605. |
[1] |
Xu Haifei, Zhao Gaiping, Yang Jiajing, Wang Xiangbin, Xu Shixiong. Three-Dimensional Finite Element Analysis of Electroacupuncture for Patients with Knee Osteoarthritis During Ascent and Descent Stair[J]. Chinese Journal of Biomedical Engineering, 2021, 40(3): 321-329. |
[2] |
Zhang Haowei, Chen Liang, Yang Junyan, Liu Ying, Zheng Yongjun. Biomechanical Study of Heel Pain During Push-off Period Based on Finite Element Method[J]. Chinese Journal of Biomedical Engineering, 2020, 39(2): 190-196. |
|
|
|
|