The mechanism of persistent undermining of a sacral pressure ulcer: Experimental analyses using a deformable model and examination of skin mobility over different anatomical locations.

Undermining is an important issue in the treatment and care of deep pressure ulcers. The frequency of the undermining over different bony prominences varies. In particular, deep pressure ulcers over the sacrum exhibit undermining more frequently than those occurring over the heel. Although shear for...

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Publicado en:Journal of Tissue Viability Vol. 29; no. 2; pp. 130 - 135
Autores principales: Tanaka, Makiko, Takahashi, Yoshiko, Hasegawa, Keiko, Ito, Yasumi, Nemoto, Tetsuya, Isogai, Zenzo
Formato: research tables/charts Journal Article
Publicado: Elsevier B.V. May2020
Acceso en línea:Ver este registro en EBSCOhost
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        0965206X
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      jtl: Journal of Tissue Viability
      issn: 0965206X
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      dt: May2020
      vid: 29
      iid: 2
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      pub: Elsevier B.V.
      place: New York, New York
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        142853445
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        10.1016/j.jtv.2020.03.001
        142853445
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        atl: The mechanism of persistent undermining of a sacral pressure ulcer: Experimental analyses using a deformable model and examination of skin mobility over different anatomical locations.
      aug:
        au:
          Tanaka, Makiko
          Takahashi, Yoshiko
          Hasegawa, Keiko
          Ito, Yasumi
          Nemoto, Tetsuya
          Isogai, Zenzo
        affil: Graduate Division of Health and Welfare, Department of Nursing and Human Nutrition, Yamaguchi Prefectural University, Yamaguchi, Japan
      sug:
        subj:
          Sacrum Pathology
          Pressure Ulcer Physiopathology
          Skin Physiology Evaluation
          Models, Structural
          Human
          Funding Source
          Japan
          Skin Tests
          Aged
          Aged, 80 and Over
          Descriptive Statistics
          Calcaneus
          Heel
          Palpation
          Skin Physiopathology
          Experimental Studies
          Aged: 65+ years
          Aged, 80 & over
      ab: Undermining is an important issue in the treatment and care of deep pressure ulcers. The frequency of the undermining over different bony prominences varies. In particular, deep pressure ulcers over the sacrum exhibit undermining more frequently than those occurring over the heel. Although shear force has been suggested as a critical factor in undermining, the exact mechanism remains unclear due to ethical and technical reasons in clinical practice. To clarify this issue, a deformable model was constructed to recreate the physical and morphological properties of a pressure ulcer with persistent undermining. The model was constructed using urethane to recreate the physical properties of a pressure ulcer. To examine the clinical relevance of the model, mechanical properties of the skin and the model were measured using a durometer. The model was further mounted onto a phantom that was laid on a bed. Backrest elevation of the bed induced deformities in the urethane model, suggesting a mechanism of persistent undermining of the sacral pressure ulcer. Moreover, a simple palpation examination in elderly volunteers revealed that the skin over the sacrum was more mobile than the skin over the heel. Therefore, persistent undermining is likely caused by specific external forces and the characteristic skin mobility of the sacral region. These two different factors explain the frequent undermining that occurs in sacral pressure ulcers. • Undermining is an important and unresolved issue for pressure ulcers. • A deformable model of pressure ulcers was mounted onto a phantom. • The elevation of the bed backrest induced deformities in the model. • Simple palpation revealed enhanced mobility of the skin over the sacrum. • This phenomenon is explained by wound deformity by specific forces and mobility.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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