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J Tissue Viability. 2010 May;19(2):35-42. doi: 10.1016/j.jtv.2009.11.002. Epub 2009 Dec 16.

The importance of internal strain as opposed to interface pressure in the prevention of pressure related deep tissue injury.

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Department of Biomedical Engineering, Eindhoven University of Technology, P/O Box 513 5600 MB Eindhoven, The Netherlands.


For pressure ulcer prevention an ambitious goal would be the establishment of a mechanical threshold for tissue damage. In the past, several researchers have sought to establish such a threshold often involving the loading time. However, they have not resulted in a unique reliable value that could be used in practice. This limitation is probably due to the focus on interface pressure. The objective of this paper is to clarify to an audience with no conventional background in mechanics, why interface pressure is not the appropriate parameter to define a damage threshold, whereas internal local deformations (strains) may prove more suitable. The paper reveals that it may be possible to identify a damage threshold for healthy skeletal muscle tissue based on local internal deformations.

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