Pressure reliefs are recommended to wheelchair bound individuals to control and minimize skin damage. To this date recommendation on duration and intervals between pressure reliefs is not clear. Recent studies have shown a relationship between reduction in tissue perfusion and oxygenation due to pressure and skin pathophysiologic changes.
We have developed a fiber-optics probe that allows measurement of oxygenation in addition to perfusion in real time; this low profile probe can be utilized while sitting and during pressure reliefs.
We have conducted a clinical trial at the National Rehabilitation Hospital on individual with spinal cord injury. The overriding goal of this project was to develop the evidence base for clinical recommendations on pressure reliefs. Results of the study will be presented.
Skin perfusion and oxygenation is easily disrupted by imposed pressure. Fiber optics probes, particularly those spectroscopy or Doppler based, may relay misleading information about tissue microcirculation dynamics depending on external forces on the sensor. Such forces could be caused by something as simple as tape used to secure the fiber probe to the test subject, or as in our studies by the full weight of a patient with spinal cord injury (SCI) sitting on the probe. We are conducting a study on patients with SCI conducting pressure relief maneuvers in their wheelchairs. This study aims to provide experimental evidence of the optimal timing between pressure relief maneuvers. We have devised a wireless pressure-controlling device; a pressure sensor positioned on a compression aluminum plate reads the imposed pressure in real time and sends the information to a feedback system controlling two position actuators. The actuators move accordingly to maintain a preset value of pressure onto the sample. This apparatus was used to monitor the effect of increasing values of pressure on spectroscopic fiber probes built to monitor tissue oxygenation and Doppler probes used to assess tissue perfusion.