Background: Non-invasive ventilation (NIV) masks are commonly used for respiratory support where intubation or a surgical airway procedure can be avoided. However, prolonged use of NIV masks involves risk to facial tissues, which are subjected to sustained deformations caused by tightening the mask and microclimate conditions. The risk of developing such medical device-related pressure ulcers can be reduced by providing additional cushioning at the mask-face interface.
Methods: In this work, we determined differences in facial tissue stresses and strain energy densities (SEDs) while using an NIV mask, with versus without cushioning using dressing cuts (Mepilex® Lite, Mölnlycke Health Care, Gothenburg, Sweden). First, we developed a force measurement system, which was used to experimentally determine local forces applied to skin at the bridge of the nose, cheeks and chin in a convenience sample group of healthy, while using NIV mask. We further demonstrated facial temperature distributions post use of the mask, using infrared thermography. Next, using the finite element method, we applied the measured compressive forces per site of the face in the model, and compared maximal effective stresses and SEDs in facial tissues, with versus without the dressing cuts.
Results & Conclusions: The dressing cuts demonstrated biomechanical effectiveness in alleviating facial skin and underlying tissue deformations and stresses, by providing localized cushioning to the tissues at-risk.