Surfaces for Health
The objective of this project is to develop supporting surfaces that reduce the risk of decubitus ulcers by optimising the contact conditions between skin and the supporting surface. This will be achieved by creating an optimised microclimate and by using surface engineering to control the combined normal and shear forces in the contact.
Decubitus ulcers, or pressure ulcers, are localized injuries to the skin and/or the underlying tissue, usually over a bony prominence, as a result of pressure in combination with shear or friction , . It has long been established that the tangential stresses caused by shear/friction are an important risk factor in the development of decubitus ulcers. These wounds are difficult to cure, can be extremely painful, are potentially life threatening and often result in an increased need of care of the patient and a lengthened hospital stay. Elderly people are most often affected, but also younger people, e.g. with a spinal cord injury, a prosthetic limb or after surgery and even new-born infants can suffer from decubitus ulcers.
In the proposed research, specialists in the fields of Tribology, Soft Tissue Biomechanics and Clinical Rehabilitation Technology collaborate to prevent pressure ulcers. The integration of the knowledge that is available in these specialist fields provides a unique research environment. The proposed project has three main focus areas. Firstly, to quantify the occurring normal and tangential (friction/shear) stresses and the strains inside the tissue as a function of the properties of the contact between the skin and the supporting surface, the mechanical load, environmental conditions and the surface micro-geometry. Typical aspects in this subject are the adhesion and deformation behaviour of the skin. The second subject of research is the use of biomarkers as an indicator for the development of skin injuries. The release of cytokines as a function of thermo-mechanical loading of the skin will be studied with particular focus on the influence of (tangential) friction loads. Thirdly, the sensitivity to decubitus of healthy subjects and spinal cord injury patients will be studied.
The experimental work will initially be performed in a laboratory setting, using in-vitro and in-vivo test. Validation of the developed models will be done by performing non-invasive tests on healthy subjects and, eventually, on patients in a clinical setting under medical supervision and after Medical Ethical approval.