Soft Tissue Deformations under the Weight-bearing Sacrum while Using a Prophylactic Dressing in Combination with Support Surfaces: MRI Studies

Sacral pressure ulcers are the most common form of pressure ulcers (PUs) in bedridden patients. The risk for sacral PUs can be reduced by using protective support surfaces and equipment prescribed for sacral PU prevention. In this work, we conducted MRI studies of sustained tissue distortion in healthy subjects protected by different combinations of medical devices and equipment in order to directly determine the effect of specific protective devices on skeletal muscle, subcutaneous fat and skin tissue deformations under the weight-bearing sacrum. We specifically measured tissue thickness changes in the weight-bearing skin, subcutaneous fat and muscle directly under the sacrum and compared the following conditions: lying supine on a rigid surface – the bare MRI table (reference, or “worst case” condition), lying on a standard foam mattress, lying on a mattress plus using the Mepilex® Border Sacrum prophylactic dressing or Tortoise® positioning system (Mölnlycke Health Care, Gothenburg, Sweden), and simultaneously using the mattress, dressing and Tortoise® protective equipment. We found that adding the above protective means reduced the extent of sustained tissue deformations with each component adding additional protection in terms of tissue thickness preservation. Hence, using the above protective measures, separately or in combination, reduces the risk for sacral PUs, and the best outcomes are achieved when all the components are used together.