Non-invasive monitoring of deep tissue injury
Pressure ulcers are localised injuries to the skin and/or underlying tissue due to mechanical loading. Deep tissue injury (DTI) is a severe type of pressure ulcer originating subcutaneously. As a result they are often undetected until the wound has evolved to the skin surface, exposing a category III or IV pressure ulcer. Healing of these wounds is a challenging process, sometimes requiring surgical intervention. Individuals with a spinal cord injury have a high risk of developing deep tissue injury, since decreased or lacking sensation makes them unaware of a developing wound. As visual inspection is not sufficient to detect deep tissue injury, other methods need to be developed.
To develop a monitoring method of deep tissue injury several techniques are used. To better understand the aetiology of DTI, physiological changes due to mechanical loading are studied in a rat model. Physiological changes are assessed with magnetic resonance imaging (MRI), histology, blood and urine analyses. MRI based finite element analysis (FEA) is performed to determine the relationship between internal tissue state and tissue damage. Temporal profiles of biomarkers released due to mechanical insult will be studied using blood and urine analysis. From this data a kinetics model can be derived.
Furthermore, human studies will be performed to understand and interpret the biomarker concentrations in spinal cord injured subjects.