Computational Modeling in Prevention and Treatment of Chronic Wounds

Sustained internal mechanical deformations in tissues during immobile weight-bearing postures (e.g. in bed or in a wheelchair) were identified as a fundamental cause for the onset and progression of pressure ulcers, particularly of the deep tissue injury type. The sustained deformations in tissues may compromise tissue viability by distorting cell shapes and the vasculature/lymphatic networks. This talk will review our record of published research concerning the effects of sustained deformations on soft tissues, with a focus on how minimizing tissue deformations should be a goal for maintaining cell homeostasis and tissue viability in fragile individuals. Examples concern the immersion and envelopment of the buttocks by wheelchair cushions, which determine the exposure to stress and strain concentrations in soft tissues near the bony prominences of the pelvis; the function and mechanisms of action of prophylactic dressings aimed at minimizing tissue deformations in the supported heel in order to avoid heel ulcers, e.g. during a surgical procedure; and, treatment of existing wounds by means of closure devices and techniques, from a perspective of minimizing exposure to sustained deformations.