Development of a model to demonstrate the effects of friction and pressure on skin in relation to pressure ulcer formation

Pressure ulcers are a common injury of the skin which leads to pain and potential infection for patients and financial burden to the healthcare providers across the global due to treatment costs, litigation and extended hospital stays. The current study focuses on one of the causes of pressure ulcer formation, ischemia. Blood vessels are deemed to be deformed and blood flow restricted when skin is subjected to external mechanical loads including friction, pressure and the combination of both. Hence, normal oxygen delivery to cells or metabolic waste removal are locally stopped which causes cells deaths and ultimately pressure ulcers.
The current study proposes a 3D finite element analysis model which is capable of demonstrating the effect of friction, pressure and the combination of both to the deformation of blood vessels. The results of simulation suggested that applied pressure collapsed the blood vessels while friction opened up the blood vessels. However, as a combination effect of pressure and friction, the cross-sectional areas of blood vessels were reduced significantly. This model is clinically and physiologically relevant in terms of loading regime and blood vessels structures. The model with further development can be adopted to be an effective tool to evaluate the effects of medical devices to the possibility of pressure ulcer formation.