• The quantification of human tissue deformations when subjected to the bodyweight using coupling between magnetic resonance imaging (MRI) and finite element computer modeling for studies of magnitudes and distributions of tissue deformations and loads.

 

• The effects of exposure to bodyweight loads on the physiology of soft tissues, including for example the impact on transport of metabolites in tissues, on perfusion and in particular the relationship between sustained deformations and transport in tissues and cells.

 

• Zoom-in to the level of individual cells and cell organelles, and discussion regarding the effects of sustained deformations on possible cytoskeletal damage and poration of the plasma membrane of deformed cells, which will cause loss of homeostasis and eventually, cell and tissue death in pressure injuries.

 

• Implementation of the above basic science findings in clinical practice and in cushion selection for either wheelchair users or chronic sitting needs: 

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         - Adequate immersion and envelopment of the body, which together represent the potential cushioning performance                      through minimization of internal tissue deformations, strains and stresses. 

         

         - Adjustability of the cushion, as body types vary considerably among people, and can change substantially over time,                     especially given the remarkable disuse-related anatomical and physiological changes during months and years of                         chronic sitting.

 

         - Adaptability, as the cushion has to be able to accommodate changes in posture and weight shifts associated with daily                living or even to change of clothing throughout the entire period of intended use.

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         - Durability, the cushion should maintain its physical and mechanical properties as well as its performance over several                   years, despite exposure to degenerating conditions e.g. temperature changes, wear against materials and exposure to                   body fluids.

 

• Given the recent advancements in understanding the etiology of pressure injuries and the availability of novel tools and research methodologies to assess cushion efficacies, there are still considerable gaps between public policy and current practice in cushion evaluation, and the challenges and measures that should be applied.

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By the end of the seminar, the participant will be able to:

 

• Define suspected deep tissue injury according to the EPUAP / NPUAP staging guidelines

• Identify two ways finite element modeling could improve pressure injury outcomes

• Explain three differences in progression of superficial versus deep pressure injuries

• Contrast three differences in the pathology of pressure injuries related to deformation versus ischemia