How Medical Devices Potentially Create Pressure Ulcers

Faculty of Health Sciences, University of Southampton, UK and Department of Biomedical Engineering, Eindhoven University of Technology, the Netherlands

To achieve the critical functionality, many medical devices apply prolonged mechanical loading to skin tissues of individual ranging from pre-term infants to elderly adults with tissue tolerance levels compromised by a range of co-morbidities. This mechanical state presents a complex interaction, which can lead to tissue breakdown, in the form of medical device-related pressure ulcers (MDRPU). This leads to device rejection and the associated cost implications of wasted resources. In most cases, functional medical devices are generally in a fixed position on the skin with limited capacity for off-loading. This presentation will discuss the current state in which devices are based on generic designs, not accommodating for patient variability, employ relatively stiff materials which do not match the mechanical compliance of potentially vulnerable skin and provide inadequate guidance to patients and clinicians for their application. Examples of the effects of a number of existing designs of medical devices will be discussed and the importance of the magnitude and duration of their applications will be highlighted (Worsley et al. 2016; 2018). Such studies can identify critical features for future designs based on selected bioengineering techniques, incorporating sensors to alert early signs of damage.

Worsley PR, Prudden G, Gower G, Bader DL. (2016) Investigating the effects of strap tension during non-invasive ventilation mask application: a combined biomechanical and biomarker approach. Med Devices (Auckl). 9:409-417
Worsley PR, Stanger ND, Horrell AK, Bader DL (2018) Investigating the effects of cervical collar design and fit on the biomechanical and biomarker reaction at the skin. Med Devices (Auckl). 11, 87-94.