Device-related pressure ulcers from a biomechanical perspective

Area of Science:

• Biomedical Engineering
• Pediatric Care
• Medical Device Design

Background:

• Pressure ulcers (PUs) in children differ from adults, with over 50% linked to medical equipment.
• Understanding mechanical loads on infant tissues is crucial for preventing device-related PUs.

Purpose of the Study:

• To quantify mechanical loads on a newborn's scalp from medical devices.
• To assess the impact of a doughnut-shaped headrest on scalp tissue mechanics.
• To identify risks associated with specific device placements.

Main Methods:

• Utilized finite element computational modeling to simulate a newborn's head.
• Analyzed mechanical stresses (von Mises, shear) and strain energy density (SED) in scalp tissues.
• Compared mechanical states with and without a doughnut-shaped headrest and with different devices (electrode, wire).

Main Results:

• An interfering wire caused the most severe mechanical conditions, increasing effective stresses by 345% in skin and 50% in fat.
• A lodged electrode also elevated tissue stresses.
• The doughnut-shaped headrest did not mitigate but potentially exacerbated stress concentrations.

Conclusions:

• Misplaced medical devices and doughnut-shaped headrests pose a significant risk for device-related PUs in newborns.
• Clinical guidelines should emphasize routine inspection of medical device placement.
• Improved medical equipment design is necessary to protect pediatric patients from PUs.