Browse > Article
http://dx.doi.org/10.5143/JESK.2010.29.6.875

The Effects of Alternating Set Pressure Changes on Dynamic Tissue Perfusion Characteristics  

Won, Byeong-Hee (Department of Mechanical Design and Mechatronics, Hanyang University)
Song, Chang-Seop (Department of Mechanical Design and Mechatronics, Hanyang University)
Publication Information
Journal of the Ergonomics Society of Korea / v.29, no.6, 2010 , pp. 875-887 More about this Journal
Abstract
The quantitative effectiveness of powered support surfaces such as APAM in preventing and treating pressure ulcers has not been sufficiently evaluated because of uncertainty of alternating pressure load input and lack of interpretation of dynamic perfusion characteristics of soft tissue. The aim was to verify the dynamic loading effects to sacral tissue perfusion characteristics from alternating set pressure changes. We developed integrated experiment system to supply alternating load to supinely positioned sacrum and concurrently measured $TcPO_2$, $TcPCO_2$ and air cell pressure. Ten aged subjects (5 female, 5 male) were tested with alternating set pressure 20, 30, 40, 50 and 60mmHg. From the dynamic perfusion response eight characteristic parameters were proposed such as average, minimum, maximum and perfusion range regarding to $TcPO_2$ and $TcPCO_2$. A one-way ANOVA was carried out to determine whether the manipulation of alternating set pressure had any effect on $TcPO_2$ and $TcPCO_2$. From the dynamic tissue perfusion response we found mean $TcPO_2$ decreased exponentially as alternating pressure load increased and perfusion range varied mainly because of minimum level change of $TcPO_2$. And perfusion range of $TcPCO_2$ affected by increase of maximum value of $TcPCO_2$. From the results we can get more strict insights about actual physiological dynamic tissue perfusion mechanism under alternating pressure load.
Keywords
Pressure ulcers; Alternating pressure profile; APAM(alternating pressure air mattress); Transcutaneous gas tension; Dynamic tissue perfusion;
Citations & Related Records
Times Cited By KSCI : 1  (Citation Analysis)
연도 인용수 순위
1 NPUAP and EPUAP, Pressure ulcer prevention and treatment - clinical practice guideline, National Pressure Ulcer Advisory Panel, 2009.
2 Petersen, N. C., The development of pressure sores during hospitalization, Bed sore biomechanics, pp. 219-224, The MacMillan press, 1976.
3 Reswick, J. B. and Rogers, J. E., Experience at Rancho Los Amigos Hospital with devices and techniques to prevent pressure sores, Bed sore Biomechanics, 301-310., The Macmillan Press, 1976.
4 Rithalia, S. V. S. and Gonsalkorale, M., Quantification of pressure relief using interface pressure and tissue perfusion in alternating pressure air mattresses, Archives of Physical Medicine and Rehabilitation, 81, 1364-1369, 2000.   DOI
5 Tissue Viability Society, Laboratory measurement of the interface pressure applied by active therapy support surfaces: A consensus document, Journal of Tissue Viability, 19, 2-6, 2010.   DOI
6 Vanderwee, K., Grypdonck, M. and Defloor, T., Alternating pressure air mattresses as prevention for pressure ulcers: A literature review, International Journal of Nursing Studies, 45, 784-801, 2008.   DOI
7 Won, B. H. and Song, C. S., Alternating pressure profile characteristics of powered pressure ulcer preventing devices, Journal of Ergonomic Society of Korea, 29(4), 639-646, 2010.   과학기술학회마을   DOI
8 Wywialowski, E. F., Tissue perfusion as a key underlying concept of pressure ulcer development and treatment, Journal of Vascular Nursing, March, 12-16, 1999.
9 Bader, D. L., The recovery characteristics of soft tissues following repeated loading, Journal of Rehabilitation Research and Development, 27(2), 141-150, 1990.c   DOI
10 Bouton, et al. The etiology of pressure sores: skin deep or muscle bound?, Archives of Physical Medicine and Rehabilitation, 84, 616-619, 2003.   DOI   ScienceOn
11 Carter, R., Transcutaneous Carbon Dioxide and Oxygen monitoring in the adult patient, The Buyer's Guide to Respiratory Care Products, (pp 102-109), European Respiratory Society, 2008.
12 Collin, D. and Saumet, J. L., Influence of external pressure on transcutaneous oxygen tension and laser Doppler flowmetry on sacral skin, Clinical Physiology, 16, 61-72, 1996.   DOI
13 Harel, F., et al. Arterial flow measurements during reactive hyperemia using NIRS, Physiological Measurement, 29, 1033-1040, 2008.   DOI
14 Jonsson, A., et al. Evaluation of antidecubitus mattresses, Medical & Biological Engineering & Computing, 43, 541-547, 2005.   DOI
15 Mathieu, A. and Mani, R., A review of the clinical significance of tissue hypoxia measurements in lower extremity wound management, Int'l J. Lower Extremity Wounds, 6(4), 273-283, 2007.   DOI
16 Makhsous, M., et al. Measuring tissue perfusion during pressure relief maneuvers: Insights into preventing pressure ulcers, The Journal of Spinal Cord Medicine, 30(5), 497-507, 2007.   DOI