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Role Of Ischemia And Deformation In The Onset Of Compression-induced Deep Tissue Injury: MRI-based Studies In A Rat Model.

A. Stekelenburg, G. Strijkers, H. Parusel, D. Bader, K. Nicolay, C. Oomens
Published 2007 · Medicine

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A rat model was used to distinguish between the different factors that contribute to muscle tissue damage related to deep pressure ulcers that develop after compressive loading. The separate and combined effects of ischemia and deformation were studied. Loading was applied to the hindlimb of rats for 2 h. Muscle tissue was examined using MR imaging (MRI) and histology. An MR-compatible loading device allowed simultaneous loading and measurement of tissue status. Two separate loading protocols incorporated uniaxial loading, resulting in tissue compression and ischemic loading. Uniaxial loading was applied to the tibialis anterior by means of an indenter, and ischemic loading was accomplished with an inflatable tourniquet. Deformation of the muscle tissue during uniaxial loading was measured using MR tagging. Compression of the tissues for 2 h led to increased T2 values, which were correlated to necrotic regions in the tibialis anterior. Perfusion measurements, by means of contrast-enhanced MRI, indicated a large ischemic region during indentation. Pure ischemic loading for 2 h led to reversible tissue changes. From the MR-tagging experiments, local strain fields were calculated. A 4.5-mm deformation, corresponding to a surface pressure of 150 kPa, resulted in maximum shear strain up to 1.0. There was a good correlation between the location of damage and the location of high shear strain. It was concluded that the large deformations, in conjunction with ischemia, provided the main trigger for irreversible muscle damage.
This paper references
Etiology of decubitus ulcers.
M. Kosiak (1961)
10.5860/choice.34-5424
Encyclopedia of nuclear magnetic resonance
Editors-in-chief (1996)
10.1152/JAPPLPHYSIOL.00889.2005
Compression-induced deep tissue injury examined with magnetic resonance imaging and histology.
A. Stekelenburg (2006)
10.1097/01241398-198507000-00002
Relationship of Spine Deformity and Pelvic Obliquity on Sitting Pressure Distributions and Decubitus Ulceration
D. Drummond (1985)
10.1053/APMR.2003.50038
The etiology of pressure ulcers: skin deep or muscle bound?
C. Bouten (2003)
10.1682/JRRD.2003.09.0433
Pressure ulcers in veterans with spinal cord injury: a retrospective study.
S. Garber (2003)
10.1002/mrm.1910300207
Improved myocardial tagging contrast.
S. Fischer (1993)
10.1152/ajpcell.1988.255.3.C377
Intracellular sodium flux and high-energy phosphorus metabolites in ischemic skeletal muscle.
H. Blum (1988)
10.1152/JAPPLPHYSIOL.00207.2003
Assessment of skeletal muscle mass in men with spinal cord injury using dual-energy X-ray absorptiometry and magnetic resonance imaging.
C. Modlesky (2004)
Metabolic alterations of skeletal muscle during ischaemia and reperfusion.
C. A. D. Da Cruz (1997)
10.1007/3-540-28804-X_7
Prevention and Treatment of Pressure Ulcers Using Electrical Stimulation
T. Janssen (2005)
An animal model and computer-controlled surface pressure delivery system for the production of pressure ulcers.
R. Salcido (1995)
10.1016/S0003-9993(98)90138-1
Seat cushion optimization: a comparison of interface pressure and tissue stiffness characteristics for spinal cord injured and elderly patients.
D. Brienza (1998)
10.1002/JMRI.20092
Assessment of skeletal muscle perfusion by contrast medium first-pass magnetic resonance imaging: technical feasibility and preliminary experience in healthy volunteers.
A. Lutz (2004)
10.1016/S0730-725X(98)00088-5
Simultaneous measurement of perfusion and oxygenation changes using a multiple gradient-echo sequence: application to human muscle study.
V. Lebon (1998)
In vitro models to study compressive strain-induced muscle cell damage.
C. Bouten (2003)
10.1016/0021-9290(81)90015-4
Interstitial fluid flow as a factor in decubitus ulcer formation.
N. Reddy (1981)
10.1097/00006534-198011000-00008
Differential Response of Skin and Muscle in the Experimental Production of Pressure Sores
G. Nola (1980)
10.1016/0363-5023(92)90400-J
Effects of reperfusion intervals on skeletal muscle injury beneath and distal to a pneumatic tourniquet.
R. Pedowitz (1992)
10.1152/ajpendo.1993.264.4.E655
Energy metabolism and adenine nucleotide degradation in twitch-stimulated rat hindlimb during ischemia-reperfusion.
D. Welsh (1993)
10.1097/00129334-200203000-00008
The Cost of Illness of Pressure Ulcers in the Netherlands
J. Severens (2002)
10.1016/0730-725X(91)90411-E
Observation of rat hind limb skeletal muscle during arterial occlusion and reperfusion by 31P MRS and 1H MRI.
S. Morikawa (1991)
10.1002/path.1700660203
An experimental study of some pressure effects on tissues, with reference to the bed-sore problem.
T. Husain (1953)
Decubitus ulcers: role of pressure and friction in causation.
S. Dinsdale (1974)
10.12968/JOWC.2000.9.1.25939
Pressure-induced skin lesions in pigs: reperfusion injury and the effects of vitamin E.
R. Houwing (2000)
10.1007/BF02348096
Monitoring the biomechanical response of individual cells under compression: A new compression device
E. Peeters (2006)
10.1097/00129334-200501000-00016
Pressure‐Related Deep Tissue Injury under Intact Skin and the Current Pressure Ulcer Staging Systems
M. Ankrom (2005)
Cellular responses to tissue distortion. In: Pressure Sores: Clinical Practice and Scientific Approach, edited by DL Bader
TJ Ryan (1990)
Prevention and treatment of pressure ulcers using electrical stimulation In: Pressure Ulcer Research: Current and Future Perspectives
Twj Janssen (2005)
10.1016/J.MEDENGPHY.2005.07.005
A new MR-compatible loading device to study in vivo muscle damage development in rats due to compressive loading.
A. Stekelenburg (2006)
Skeletal muscle evaluated by MRI. In: Encyclopedia of Nuclear Magnetic Resonance, edited by DM Grant and RK Harris
JL Fleckenstein (1996)
10.1097/00003086-200401000-00045
Tourniquet-Induced Ischemia and Reperfusion in Human Skeletal Muscle
B. Östman (2004)
10.1152/ajpheart.1986.250.2.H213
Metabolic response of skeletal muscle to ischemia.
K. Harris (1986)
Skeletal Muscle Pathology after Spinal Cord Injury : Our 20 Year Experience and Results on Skeletal Muscle Changes in Paraplegics , Related to Functional Rehabilitation
R. Scelsi (2002)
Etiologic factors in pressure sores: an experimental model.
R. Daniel (1981)
10.1148/radiology.193.2.7972757
Skeletal muscle contraction: analysis with use of velocity distributions from phase-contrast MR imaging.
J. Drace (1994)
10.1111/J.1067-1927.2005.130213.X
Analysis of ischemia-reperfusion injury in a microcirculatory model of pressure ulcers.
Shinsaku Tsuji (2005)
10.1016/0022-4804(92)90081-A
Skeletal muscle injury induced by a pneumatic tourniquet: an enzyme- and immunohistochemical study in rabbits.
R. Pedowitz (1992)
Magn Reson Imaging
(1991)
10.1007/978-1-349-10128-3
Pressure Sores - Clinical Practice and Scientific Approach
D. Bader (1990)
Klinische beobachtungen und experimentelle studien uber die entstehung des dekubitus
KE Groth (1942)
10.1148/radiology.171.3.2717762
MR imaging of motion with spatial modulation of magnetization.
L. Axel (1989)
Lymphatic clearance during compressive loading.
G. Miller (1981)
10.1046/J.0021-8782.2001.00008.X
Evans Blue Dye as an in vivo marker of myofibre damage: optimising parameters for detecting initial myofibre membrane permeability.
P. W. Hamer (2002)
10.1002/jor.1100080616
An animal model for the study of neuromuscular injury induced beneath and distal to a pneumatic tourniquet.
R. Pedowitz (1990)
10.1016/J.APMR.2005.11.020
Long-term prevention of pressure ulcers in high-risk patients: a single case study of the use of gluteal neuromuscular electric stimulation.
K. Bogie (2006)
10.1016/0021-9290(82)90003-3
Model experiments to study the stress distributions in a seated buttock.
N. Reddy (1982)
10.1093/AGEING/27.2.217
The viability of soft tissues in elderly subjects undergoing hip surgery.
D. Bader (1998)
10.1002/NBM.1095
Dynamic MRS and MRI of skeletal muscle function and biomechanics.
J. Prompers (2006)
10.1016/S1350-4533(01)00034-0
Quantification and localisation of damage in rat muscles after controlled loading; a new approach to study the aetiology of pressure sores.
E. Bosboom (2001)
10.1080/1025584031000121034
Can Loaded Interface Characteristics Influence Strain Distributions in Muscle Adjacent to Bony Prominences?
C. Oomens (2003)
10.1002/(SICI)1522-2594(199912)42:6<1048::AID-MRM9>3.0.CO;2-M
Cardiac motion tracking using CINE harmonic phase (HARP) magnetic resonance imaging.
N. Osman (1999)
10.1007/978-1-349-10128-3_11
Cellular Responses to Tissue Distortion
T. Ryan (1990)
10.12968/JOWC.2005.14.5.26774
Should we include deep tissue injury in pressure ulcer staging systems? The NPUAP debate.
J. Donnelly (2005)
10.1114/1.1624602
Compression Induced Cell Damage in Engineered Muscle Tissue: An In Vitro Model to Study Pressure Ulcer Aetiology
R. G. Breuls (2004)
10.1007/BF00357633
Skeletal muscle damage during tourniquet-induced ischaemia
H. J. Appell (2004)
Skeletal muscle evaluated by MRI In: Encyclopedia of Nuclear Magnetic Resonance
Jl Fleckenstein (1996)
10.1007/978-1-349-10128-3_14
Biomechanics of Tissue Distortion and Stiffness by Magnetic Resonance Imaging
S. Reger (1990)
10.1016/0020-7683(95)00240-5
Computing strain fields from discrete displacement fields in 2D-solids
M. Geers (1996)
10.1002/9780470034590.EMRSTM0509
Skeletal Muscle Evaluated by MRI
J. Fleckenstein (2007)
Strain fields within contracting skeletal muscle
M. M. Maenhout (2001)
10.1152/JAPPL.1999.86.1.350
Influence of complete spinal cord injury on skeletal muscle within 6 mo of injury.
M. Castro (1999)
10.1046/J.1524-475X.2000.00068.X
Ischemia-reperfusion injury in chronic pressure ulcer formation: a skin model in the rat.
S. Peirce (2000)
10.1016/J.JBIOMECH.2006.06.020
Assessment of mechanical conditions in sub-dermal tissues during sitting: a combined experimental-MRI and finite element approach.
E. Linder-Ganz (2007)
Decubitus ulcers: role of pressure and friction in causation.
Dinsdale Sm (1974)
10.1002/JMRI.10169
Evaluation of tissue perfusion in a rat model of hind-limb muscle ischemia using dynamic contrast-enhanced magnetic resonance imaging.
Yanping Luo (2002)



This paper is referenced by
10.1111/j.1525-1594.2011.01212.x
The effects of intermittent electrical stimulation on the prevention of deep tissue injury: varying loads and stimulation paradigms.
Cara A. Curtis (2011)
Myoglobin and troponin concentrations are increased in early stage deep tissue injury
G. J. Strijkersb (2019)
10.1177/0309364613476534
Influence of distance between the rotation axis of back support and the hip joint on shear force applied to buttocks in a reclining wheelchair’s back support
K. Kobara (2013)
How much time does it take to get a pressure ulcer? Integrated evidence from human, animal, and in vitro studies.
A. Gefen (2008)
10.1016/j.jtbi.2011.08.022
Deformation and reperfusion damages and their accumulation in subcutaneous tissues during loading and unloading: a theoretical modeling of deep tissue injuries.
Arthur Fuk-Tat Mak (2011)
The accuracy of ultrasound, thermography, photography and sub-epidermal moisture as a predictor of pressure ulcer presence – a systematic review
De Oliveira (2015)
Investigating the influence of intermittent and continuous mechanical loading on skin through non-invasive sampling of IL-1α
P. R. Worsleya (2019)
10.1007/s10237-007-0097-7
Microstructural analysis of deformation-induced hypoxic damage in skeletal muscle
Kk Karlien Ceelen (2007)
10.1115/1.2987877
Validation of a numerical model of skeletal muscle compression with MR tagging: a contribution to pressure ulcer research.
K. Ceelen (2008)
10.1007/S11340-007-9093-1
Changes in Intracellular Calcium during Compression of C2C12 Myotubes
Kk Karlien Ceelen (2009)
10.1155/2012/541383
A System Utilizing Metal Hydride Actuators to Achieve Passive Motion of Toe Joints for Prevention of Pressure Ulcers: A Pilot Study
Minako Hosono (2012)
10.1007/s40719-018-0152-0
An Overview of Sacral Decubitus Ulcer
Joana Abed Elahad (2018)
10.1016/j.jbiomech.2008.09.016
Compression-induced damage and internal tissue strains are related.
K. Ceelen (2008)
10.1016/j.clinbiomech.2019.02.015
There is an individual tolerance to mechanical loading in compression induced deep tissue injury
Willeke A Traa (2019)
10.1177/0309364613486918
The effect of seat shape on the risk of pressure ulcers using discomfort and interface pressure measurements
L. Tasker (2014)
Development of a Tool for Pressure Ulcer Risk Assessment and Preventive Interventions in Ancillary Services Patients
M. S. Messer (2012)
10.1016/j.jtv.2009.10.004
Candidate biomarkers for deep tissue damage from molecular biological and biochemical aspects.
T. Minematsu (2010)
10.1152/japplphysiol.00389.2011
The effects of deformation, ischemia, and reperfusion on the development of muscle damage during prolonged loading.
S. Loerakker (2011)
10.1080/10255842.2011.627682
How does muscle stiffness affect the internal deformations within the soft tissue layers of the buttocks under constant loading?
S. Loerakker (2013)
NHG-Standaard Decubitus (eerste herziening)
Tjerk Wiersma (2015)
10.1016/j.jmbbm.2016.03.006
Improving the effect of shear on skin viability with wound dressings.
Luuk A. de Wert (2016)
10.1097/01.ASW.0000305403.89737.6c
Bioengineering Models of Deep Tissue Injury
A. Gefen (2008)
Personnalisation des propriétés mécaniques des tissus mous du fessier humain par méthodes d'éléments finis et expérimentations In Vivo.
Pierre-Luc Beaudette (2009)
10.1016/S0021-9290(06)84334-4
Microstructural analysis of deformation-induced hypoxic damage in skeletal muscle.
K. Ceelen (2008)
10.1016/j.jmbbm.2018.12.026
Myoglobin and troponin concentrations are increased in early stage deep tissue injury.
W. Traa (2019)
10.7748/NS2009.07.23.45.64.C7115
Reswick and Rogers pressure-time curve for pressure ulcer risk. Part 2.
A. Gefen (2009)
10.1080/10255842.2010.529804
Cellular-scale transport in deformed skeletal muscle following spinal cord injury
Yael Ruschkewitz (2011)
10.3233/ABB-2011-0027
Preventing ischial pressure ulcers: I. Review of neuromuscular electrical stimulation
Hilton M. Kaplan (2011)
10.1016/j.jbiomech.2015.12.022
Membrane permeability during pressure ulcer formation: A computational model of dynamic competition between cytoskeletal damage and repair.
N Suhas Jagannathan (2016)
10.1016/j.ijnurstu.2011.10.007
Multi-stage versus single-stage inflation and deflation cycle for alternating low pressure air mattresses to prevent pressure ulcers in hospitalised patients: a randomised-controlled clinical trial.
L. Demarré (2012)
Contribution à l'évaluation du risque lésionnel lors d'un contact prolongé à l'aide de la méthode des éléments finis. Application à l'étude de l'assise.
A. Macron (2019)
Ten top tips: repositioning a patient to prevent pressure ulcers Clinical practice
Zena Moore (2014)
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