Prevention of pressure ulcers

The loss of tissue integrity evidenced by pressure ulcers, diabetic foot ulcers, venous stasis ulcers, and chronically swollen limbs are examples of common, chronic medical conditions (Brienza et al., 1996a). Characterized by chronicity and relapse, these conditions are among the most costly, yet preventable of soft tissue injuries. Excessive, unevenly applied or repetitive tissue loading is a common contributory factor in all of these conditions. In-depth knowledge of the interaction between externally applied pressure and the soft tissue is crucial to the prevention, early detection, and management of soft tissue injuries.

Injury depends on the duration and intensity of tissue loading as well as the characteristics of both the tissue and the interfacing support surface. Recent work has resulted in significant findings and developments. Brienza et al. (1996b) developed a system for the analysis of seat support surfaces using shape control and simultaneous measurement of applied pressures. The system has been used to investigate the biomechanical factors for predicting pressure ulcer risk (Wang et al., 1998, 2000). In a randomized control trial pressure-reducing seat cushions for elderly wheelchair users were found to reduce the incidence and severity of pressure ulcers (Geyer et al., 2001). In an investigation of the relationship between pressure ulcer incidence and buttock-seat cushion interface pressure in at-risk elderly wheelchair users showed that lower interface pressures corresponded to fewer pressure ulcers (Brienza et al., 2001).

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