Numerical Simulation of Skin Pressure Distribution Applied by Graduated Compression Stockings

Three-dimensional dynamic homogenous modeling: The biomechanical influences of leg tissue stiffness on pressure performance of compression biomedical therapeutic textiles

Patient compliance and therapeutic precision of compression textiles (CTs) are frequently limited by the inaccurate pressure distributions along biological bodies in physical-based compression therapy. Therefore, the biomechanical influences of physiological tissue material characteristics of lower extremities on compression generations of CTs need to be explored systematically to improve pressure management efficacy. In this study, we developed three-dimensional (3D) homogenous finite element (FE) CT-leg systems to qualitatively compare the pressure diversities along lower limbs with different biomaterial tissue properties under each external compression level. Simultaneously, through the obtained leg circumferential displacement, a contact analysis model was applied to quantitatively explore the impact mechanisms of soft leg indentations on the pressure performance of CTs. Based on the experimental validation study, the proposed FE systems could be efficiently utilized for compression performance prediction (error ratio: 7.45%). Through the biomechanical simulation and theoretical calculations, the tissue stiffness characteristics of applied bodies showed significant correlations (p < 0.05) with the body circumferential displacements but no correlations (p > 0.05) with pressure delivery differences of CTs. This study facilitates the pressure fit design principle and leg mannequin material selection guidance for the development and experimental assessment of CTs. It also provides effective simulation methods for pressure prediction and property parametric optimization of compression materials.

A critical review on the three-dimensional finite element modelling of the compression therapy for chronic venous insufficiency

Compression therapy is an adjuvant physical intervention providing the benefits of calibrated compression and controlled stretch and consequently is increasingly applied for the treatment of chronic venous insufficiency. However, the mechanism of the compression therapy for chronic venous insufficiency is still unclear. To elaborate the mechanism of compression therapy, in recent years, the computational modelling technique, especially the finite element modelling method, has been widely used. However, there are still many unclear issues regarding the finite element modelling of compression therapy, for example, the selection of appropriate material models, the validation of the finite element predictions, the post-processing of the results. To shed light on these unclear issues, this study provides a state-of-the-art review on the application of finite element modelling technique in the compression therapy for chronic venous insufficiency. The aims of the present study are as follows: (1) to provide guidance on the application of the finite element technique in healthcare and relevant fields, (2) to enhance the understanding of the mechanism of compression therapy and (3) to foster the collaborations among different disciplines. To achieve these aims, the following parts are reviewed: (1) the background on chronic venous insufficiency and the computational modelling approach, (2) the acquisition of medical images and the procedure for generating the finite element model, (3) the definition of material models in the finite element model, (4) the methods for validating the finite element predictions, (5) the post-processing of the finite element results and (6) future challenges in the finite element modelling of compression therapy.

Identification of the material parameters of soft tissues in the compressed leg

Elastic compression is recommended in prophylaxis and the treatment of venous disorder of the human leg. However, the mechanisms of compression are not completely understood and the response of internal tissues to the external pressure is partially unknown. To address this later issue, a 3D FE model of a human leg is developed. The geometry is derived from 3D CT scans. The FE model is made up of soft tissues and rigid bones. An inverse method is applied to identify the properties of soft tissues which are modelled as hyperelastic, near-incompressible, homogeneous and isotropic materials. The principle is to calibrate the constitutive properties using CT scans carried out with and without the presence of a compression sock. The deformed geometry computed by the calibrated FE model is in agreement with the geometry deduced from the CT scans. The model also provides the internal pressure distribution, which may lead to medical exploitation in the future.