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At least 523 records · Page 29Linked to original sources
PubMed2001

Morphological architecture and distribution of blood capillaries and elastic fibres in the human skin.

This study was undertaken to clarify the morphological features in the blood capillary and elastic fibre distribution of the human skin in terms of susceptibility to pressure sore development. Skin tissues were obtained from bony areas: the sacrum and ischial tuberosity and non-bony area: the centre of the gluteus maximus of 5 aged subjects post mortem for examination using light and scanning electron microscopy. It was observed that the sacral skin had finger-like papillae and underneath the blood capillary loops were most numerous. In the ischial skin the dermal papillae consisted of a combination of finger-like and trapezoid shapes having moderate density of blood capillaries. In contrast, the dermal papillae in the gluteal skin were almost flat, so that the blood capillaries were scattered. The size of elastic bundles in the papillary layer of the sacral, ischial and gluteal skin ranged from 2 to 3 microns, 5 to 10 microns, and 3 to 5 microns, respectively. The elastic fibres were densely distributed in the ischial skin while less so in the sacral skin.

Aged↗
PubMed1996

Pressure-reducing capability of the Therarest hospital replacement mattress.

Pressure readings over the sacral and trochanter areas were compared between a standard hospital mattress and a hospital replacement mattress with a healthy population (n = 23). There was a 28% reduction in sacral pressures and a 29% reduction in trochanter pressures. The mean sacral pressures for 10 subjects on the standard hospital mattress were greater than 32 mm Hg, whereas only one subject on the replacement mattress had a mean sacral pressure greater than 32 mm Hg. The mean trochanter pressures for 17 subjects on the standard hospital mattress were greater than 32 mm Hg, whereas only 12 subjects on the replacement mattress had mean trochanter pressures greater than 32 mm Hg. Further research is warranted to determine the validity of applying findings from research with healthy adults to persons considered to be at risk for pressure ulcer development. Research is also indicated to determine the effects of pressure-reducing variables in an at-risk population with different pressure-reducing products.

Adult↗
PubMed2001

Analysis of pressure distribution at the body-seat interface in able-bodied and paraplegic subjects using a deformable active contour algorithm.

In this paper, a semi-automatic method for segmenting pressure distribution image-based data at the body-seat interface is presented. The purpose of this work was to estimate the surface and the load supported by the ischial tuberosity (IT) region. The proposed method involves three steps: (1) detecting the IT region using a pressure-distribution image gradient; (2) estimating the contour of the IT region by an iterative active contour algorithm and finally (3) estimating the percentage of the surface and the weight-bearing of the IT region in a group of able-bodied (AB) and spinal-cord injury (SCI) subjects. It was found in this study that the weight bearing on the IT for the spinal-cord injured group is distributed on half the surface in comparison with the AB group or the powered wheelchair users groups. The findings of this study provide insights concerning pressure distribution in sitting for the paraplegic and able-bodied.

Adult↗
PubMed1998

Pressure variation under the ischial tuberosity during a push cycle.

The present study is devoted to the variation of the magnitude of the compressive loading acting on the soft seating parts of a disabled person and the related pressure distribution under the ischial tuberosity during wheelchair propulsion. A combined experimental and computational approach was designed to predict correctly the change in magnitude of the maximum internal shear and compressive stresses produced by different propulsion speeds, cushion characteristics and body position of the subject. The results obtained show that the vertical force acting on the seating parts increases with the propulsion speed and exceeds the body weight by more than 100%. The related pressure under the ischial tuberosity shows a significant increase of 125% on the tissue/seat interface and an estimated increase of 185% in the peak compressive stress. It is concluded that computer modelling using a quasi-static approach provides a reliable estimate of the pressure values by the observed loading frequencies of 0-4 Hz. It can also be noted that the time independent material model utilised for the bulky soft tissue proved adequate for the estimate of the pressure level occurring under the ischial tuberosity during a push cycle.

Biomechanical Phenomena↗
PubMed2001

Urinary incontinence after pelvic trauma: a case report.

Stress and Urge urinary incontinence may develop after a pelvic trauma especially after pelvic bone fractures. Incontinence may persist even though any type of bladder neck suspension is performed if malunion occurs between fracture ends. In stress and urge urinary incontinence developed after pelvic trauma, patients should also be evaluated for malunion of fractures which may lead to bone spurs and during any type of bladder neck suspension these should also be removed.

Cystoscopy↗
PubMed2001

Atypical decubital fibroplasia with unusual histology.

A case of atypical decubital fibroplasia with unusual histology arising in the buttock of a 68-year-old bed-ridden male in presented. The lesion measuring 5.4 cm in greatest dimension was histologically characterized by a proliferation of fibroblasts with oval to spindle nuclei and dense fibrous stroma with focal hyalinization and calcification. Ganglion-like fibroblastic cells and multinucleated giant cells of osteoclast type were also observed. There were numerous elastic fibers within and adjacent to the proliferating stromal cells. The proliferating stromal cells were positive for vimentin and collagen type IV but negative for CAM 5.2, epithelial membrane antigen, desmin, alpha-smooth muscle actin, muscle actin, HHF35, S-100 protein and CD34. Ultrastructurally, they were of a fibroblastic nature. The hypercellularity, lack of zones of fibrinoid necrosis, lack of lobulation and the presence of multinucleated giant cells were different from the originally described lesion. This condition represents a variant of atypical decubital fibroplasia. Pathogenic factors of this lesion are considered to be chronically repeated pressure and associated intermittent ischemia. The recognition of the lesion and its distinction from a sarcoma is essential.

Aged↗
PubMed1980

Pressure sore prevention for the wheelchair-bound spinal injury patient.

The concept of a wheelchair cushion fitting clinic for the prevention of pressure sores is reviewed in the light of recent estimates of the cost of pressure sores in the U.K. A method for measuring the pressure beneath the ischial tuberosities is discussed and techniques for measuring a patient's habitual exercise frequency and seated posture are described. Results from the records of 600 spinal injury patients including Rancho Los Amigos Hospital are reported and used to demonstrate the importance of low pressure beneath the ischial tuberosities as an indicator of wheelchair cushion suitability.

Humans↗
PubMed1983

Long term pressure recordings under the ischial tuberosities of tetraplegics.

Five ulcer free tetraplegic subjects who are unable to do lift-offs were studied on four separate days on two types of wheelchair cushions to measure the pressures underneath the ischial tuberosities. Small electrical pressure transducers and a tape-recorder were utilised. The average pressures on the ROHO and foam cushions were 71.5 and 105.4 mmHg respectively. The average time between push-ups greater than 1 second and greater than 5 seconds was 72.1 and 96.2 minutes. The average pressures and the time between push-ups was greatly in excess of the usually suggested skin care regime. The data would suggest that the relative importance of pressure and pressure relief in the aetiology of decubitus ulcers should be re-examined.

Female↗
PubMed1987

Soft tissue augmentation as a method of reducing the liability to pressure sores in spinal injured patients.

The development of a procedure designed to reduce the liability to pressure sores over bony prominences is described. This employs the properties of a particular type of carbon fibre pad implanted surgically over the bony prominence. The mechanical response of the pad to loading has been examined. The host tissue response to the pad involves penetration of the interstices between the carbon fibres with organised fibrous tissue. The host-tissue--carbon fibre pad complex has been found to be highly vascular. An 'ischiobarograph' has been developed and used in order to evaluate the alteration in pressure profile produced by the presence of the implanted prosthesis (the patient being in a sitting position).

Animals↗
PubMed1992

Septic ischial bursitis in patients with spinal cord injury.

Septic ischial bursitis is described in 4 patients with spinal cord injury. In these patients a pre-existing ischial bursitis probably became secondarily infected. Because these patients lack sensation, diagnosis may be difficult. The disease process in one patient with a prolonged fever was only recognized after a leucocyte scan detected an abscess extending to the thigh. At surgery it was found that the infection extended from the ischial bursa to the upper lateral thigh. Infection in these patients was due to beta hemolytic streptococcus, S. aureus, and S. epidermidis. The patients all responded well to local drainage and excision of the bursa.

Adolescent↗
PubMed2000

Rotation flaps in the treatment of ischial pressure sores--the bigger the better.

Pressure sores are a common problem in paraplegic patients or those otherwise immobilised for long periods of time. Their surgical management is predominantly undertaken by plastic surgeons but other surgeons will also treat them from time to time. We present a case of an ischial pressure sore treated by a general surgeon with a small buttock rotation flap that subsequently broke down with recurrence of the pressure sore. The subsequent surgical management under our care was compromised by his earlier surgery but nevertheless achieved a satisfactory outcome. The need to perform repeat surgery in the future must therefore be borne in mind when planning the initial operation, so that the maximum number of reconstructive options are preserved.

Humans↗