Pressure sore etiology - highlighted with optical measurements of the blood flow

Abstract: In line with the quality awareness of good prevention of pressure sores and in treatment of those sores already developed, evaluation of antidecubitus mattresses plays an important role. However, there are shortages in the evaluations performed today, since often interface pressure is the only parameter regarded. Since ischaemia in the tissue is the primary cause of pressure sore, the focus in this thesis is on blood flow measurements in tissue exposed external loading. To study the tissue blood flow would give a better and more direct indication on the mattress effectiveness in minimizing the negative effects on the tissue viability.The results presented in this thesis reveal that the superficial blood flow in areas prone to pressure sore development, is affected by increased skin temperature and external loading of the tissue. Both the effects from pressure and shear stress have been studied.Measurements of the tissue blood flow is interesting to relate to the two theories about at which tissue layer the pressure sores start to develop. To achieved more knowledge about the pressure sore etiology and also be able to non-invasively measure the tissue blood flow for evaluations of antidecubitus mattresses an optical sensor has been developed. The sensor combines the two optical methods, laser Doppler flowmetry and photoplethysmography. With the design of the sensor, measurements of the superficial skin blood flow and the deeper blood flow, even the muscle blood flow, can be performed. Measurement depths of 2 mm, 8 mm, and 20 mm into the tissue is assumed.Preliminary result from measurements performed with the optical sensor in four test subjects, revealed great individual differences in blood flow, but also different response to the same external loading at different measurement depths, in the same individual. This new optical sensor is likely to be of great value in future studies of pressure sore etiology and in future evaluations of antidecubitus mattresses.