Clinical workflow for personalized foot pressure ulcer prevention

Area of Science:

• Biomechanics
• Medical Imaging
• Computational Modeling

Background:

• Diabetes-related neuropathy causes foot insensitivity, increasing ulcer risk.
• Deep foot pressure ulcers arise from internal tissue strain near bony structures.
• Monitoring foot tissue strain is crucial for preventing diabetic foot ulcers.

Purpose of the Study:

• To develop and validate personalized biomechanical foot models for assessing internal tissue strains.
• To determine the risk of pressure ulcer formation using patient-specific foot models.
• To investigate the influence of foot anatomy on pressure ulcer risk.

Main Methods:

• Generating patient-specific foot models by deforming an atlas to medical image contours.
• Creating biomechanical models with rigid bodies for bones and finite element meshes for soft tissues.
• Applying pressure loads to models and measuring Von Mises strains and cluster volumes in key foot regions.

Main Results:

• Significant variability in strain location and magnitude was observed among the three patient models.
• The study confirmed that individual foot anatomy influences the risk of pressure ulcer development.
• High internal strains were identified near bony structures, correlating with ulcer formation risk.

Conclusions:

• Personalized biomechanical foot models offer a promising tool for predicting diabetic foot ulcer risk.
• Understanding patient-specific foot mechanics is essential for targeted ulcer prevention.
• This methodology can aid in developing personalized interventions for high-risk diabetic patients.