Tissues Injuries from Epidermal Loadings in Prosthetics, Orthotics, and Wheeled Mobility

Abstract

Pressure ulcer is primarily a biomechanical issue, although the cascade of clinical events often involves many confounding intrinsic and extrinsic factors, such as the general health condition and the personal hygiene of the subject involved. Decades of research have clarified some mechanisms leading to pressure ulcers, though considerable controversies still remain. A number of hypotheses have been proposed for the biomechanics of pressure ulcer in past decades - a) direct mechanical insults to tissues and cells, b) local ischemia and anoxia due to blood flow occlusion, and c) reperfusion injuries. Besides pressure, shear was also noted to be a major contributor to the problem of pressure ulcer. The purpose of this plenary lecture is to review our current understanding on how epidermal loadings affect the tissues internally, and on the biomechanics of pressure ulcers formation.