Journal of Tissue Viability
Volume 18, Issue 3 , Pages 62-71 , August 2009

Patient-specific modeling of deep tissue injury biomechanics in an unconscious patient who developed myonecrosis after prolonged lying

  • Eran Linder-Ganz

      Affiliations

    • Department of Biomedical Engineering, Faculty of Engineering, Tel Aviv University, Ramat Aviv Campus, Tel Aviv 69978, Israel
    • ,
  • Nogah Shabshin

      Affiliations

    • Department of Diagnostic Imaging, Chaim Sheba Medical Center, Tel Hashomer 52621, Israel
    • ,
  • Amit Gefen

      Affiliations

    • Department of Biomedical Engineering, Faculty of Engineering, Tel Aviv University, Ramat Aviv Campus, Tel Aviv 69978, Israel
    • Corresponding Author InformationCorresponding author. Tel.: +972 3 640 8093; fax: +972 3 640 5845.

References 

  1. Black J, Baharestani M, Cuddigan J, Dorner B, Edsberg L, Langemo D, et al. the National Pressure Ulcer Advisory Panel. National Pressure Ulcer Advisory Panel's updated pressure ulcer staging system. Dermatol Nurs. 2007;19:343–349
  2. Agam L, Gefen A. Pressure ulcers and deep tissue injury: a bioengineering perspective. J Wound Care. 2007;16:336–343
  3. Gawlitta D, Oomens CW, Bader DL, Baaijens FP, Bouten CV. Temporal differences in the influence of ischemic factors and deformation on the metabolism of engineered skeletal muscle. J Appl Physiol. 2007;103:464–473
  4. Gefen A, Cornelissen LH, Gawlitta D, Bader DL, Oomens CW. The free diffusion of macromolecules in tissue-engineered skeletal muscle subjected to large compression strains. J Biomech. 2008;41:845–853
  5. Daniel RK, Priest DL, Wheatley DC. Etiologic factors in pressure sores: an experimental model. Arch Phys Med Rehabil. 1981;62:492–498
  6. Salcido R, Fisher SB, Donofrio JC, Bieschke M, Knapp C, Liang R, et al. An animal model and computer-controlled surface pressure delivery system for the production of pressure ulcers. J Rehabil Res Dev. 1995;32:149–161
  7. Gefen A, Gefen N, Linder-Ganz E, Margulies SS. In vivo muscle stiffening under bone compression promotes deep pressure sores. J Biomech Eng. 2005;127:512–524
  8. Linder-Ganz E, Engelberg S, Scheinowitz M, Gefen A. Pressure-time cell death threshold for albino rat skeletal muscles as related to pressure sore biomechanics. J Biomech. 2006;39:2725–2732
  9. Gefen A, van Nierop B, Bader DL, Oomens CW. Strain-time cell-death threshold for skeletal muscle in a tissue-engineered model system for deep tissue injury. J Biomech. 2008;41:2003–2012
  10. Gefen A. Risk factors for a pressure-related deep tissue injury: a theoretical model. Med Biol Eng Comp. 2007;45:563–573
  11. Linder-Ganz E, Gefen A. Stress analyses coupled with damage laws to determine biomechanical risk factors for deep tissue injury during sitting. J Biomech Eng. 2009;131:011003/1-13
  12. Quintavalle PR, Lyder CH, Mertz PJ, Phillips-Jones C, Dyson M. Use of high-resolution, high-frequency diagnostic ultrasound to investigate the pathogenesis of pressure ulcer development. Adv Skin Wound Care. 2006;19:498–505
  13. Ohura T, Ohura N, Oka H. Incidence and clinical symptoms of hourglass and sandwich-shaped tissue necrosis in stage IV pressure ulcers. Wounds. 2007;19:310–319
  14. Bosboom EMH, Hesselink MKC, Oomens CWJ, Bouten CVC, Drost MR, Baaijens FPT. Passive transverse mechanical properties of skeletal muscle under in vivo compression. J Biomech. 2001;34:1365–1368
  15. Stekelenburg A, Strijkers GJ, Parusel H, Bader DL, Nicolay K, Oomens CW. Role of ischemia and deformation in the onset of compression-induced deep tissue injury: MRI-based studies in a rat model. J Appl Physiol. 2007;102:2002–2011
  16. Hencey JY, Vermess M, van Geertruyden HH, Binard JE, Manchepalli S. Magnetic resonance imaging examinations of gluteal decubitus ulcers in spinal cord injury patients. J Spinal Cord Med. 1996;19:5–8
  17. Linder-Ganz E, Shabshin N, Itzchak Y, Gefen A. Assessment of mechanical conditions in sub-dermal tissues during sitting: a combined experimental-MRI and finite element approach. J Biomech. 2007;40:1443–1454
  18. Linder-Ganz E, Shabshin N, Itzchak Y, Yizhar Z, Siev-Ner I, Gefen A. Strains and stresses in sub-dermal tissues of the buttocks are greater in paraplegics than in healthy during sitting. J Biomech. 2008;41:567–580
  19. Guo XE. Mechanical properties of cortical bone and cancellous bone tissue. In:  Cowin SC editors. Bone mechanics handbook. USA: CRC Press; 2001;p. 10–23
  20. Palevski A, Glaich I, Portnoy S, Linder-Ganz E, Gefen A. Stress relaxation of porcine gluteus muscle subjected to sudden transverse deformation as related to pressure sore modeling. J Biomech Eng. 2006;128:782–787
  21. Brosh T, Arcan M. Modeling the body/chair interaction—an integrative experimental-numerical approach. Clin Biomech. 2000;15:217–219
  22. Trelstad RL, Silver FH. Matrix assembly. In:  Hay ED editors. Cell biology of extracellular matrix. New York: Plenum; 1981;p. 179–215
  23. Shanley FR. Strength of materials. New York: McGraw-Hill; 1957;p. 744
  24. Cook NH. Mechanics and materials for design (international student edition). New York: McGraw-Hill; 1985;

PII: S0965-206X(09)00009-6

doi: 10.1016/j.jtv.2009.02.004

Journal of Tissue Viability
Volume 18, Issue 3 , Pages 62-71 , August 2009

Article Tools

* Image Usage & Resolution