Microclimate evaluation of strap-based wheelchair seating systems for persons with spinal cord injury: A pilot study

Strategies in surface engineering for the regulation of microclimates in skin-medical product interactions

There is a growing number of personal healthcare devices that are in prolonged contact with the skin. The functionality of these products is linked to the interface formed by the contact between the medical apparatus and the skin. The interface can be characterised by its topology, compliance, and moisture and thermal regulating capabilities. Many devices are, however, described to have suboptimal and occlusive contacts, resulting in physiological unfavourable microclimates at the interface. The resulting poor management of moisture and temperature can impact the functionality and utility of the device and, in severe cases, lead to physical harm to the user. Being able to control the microclimate is therefore expected to limit medical-device related injuries and prevent associated skin complications. Surface engineering can modify and potentially enhance the regulation of the microclimate factors surrounding the interface between a product's surface and the skin. This review provides an overview of potential engineering solutions considering the needs for, and influences on, regulation of temperature and moisture by considering the skin-medical device interface as a system. These findings serve as a platform for the anticipated progress in the role of surface engineering for skin-device microclimate regulation.

Hygro-thermo-mechanical performance of wheelchair cushion technologies in the prevention of pressure ulcers and moisture-associated skin damages

This study aims at investigating the effects of three different wheelchair cushion technologies at the patient-wheelchair interface. To this end, eight participants were recruited to remain in an unrelieved seated position on a wheelchair successively equipped with three different cushions (foam, air-cell-based and gel), for a duration of 45 min. Interface pressure, temperature (measured with infrared thermography) and relative humidity were measured at the seat interface, at different timestamps. Experimental results show that foam cushion is significantly more efficient in reducing contact peak pressure (p < .01), while the gel cushion displays higher heat evacuation capabilities. In terms of relative humidity, no significant difference is observed among the three technologies (p > .29): all of them evacuate around only 10% of the total humidity compared to the reference situation (i.e., without cushion). Besides, a complementary numerical simulation corresponding to the steady state of the patient-wheelchair structure clearly highlights the temperature volume field at the underside of the seat, which acts like a thermal barrier and contributes to heat accumulation. Besides, an air flow at the underside of the chair in motion is shown to significantly reduce heat accumulation.

Review of Measuring Microenvironmental Changes at the Body-Seat Interface and the Relationship between Object Measurement and Subjective Evaluation

Being seated has increasingly pervaded both working and leisure lifestyles, with development of more comfortable seating surfaces dependent on feedback from subjective questionnaires and design aesthetics. As a consequence, research has become focused on how to objectively resolve factors that might underpin comfort and discomfort. This review summarizes objective methods of measuring the microenvironmental changes at the body–seat interface and examines the relationship between objective measurement and subjective sensation. From the perspective of physical parameters, pressure detection accounted for nearly two thirds (37/54) of the publications, followed by microclimatic information (temperature and relative humidity: 18/54): it is to be noted that one article included both microclimate and pressure measurements and was placed into both categories. In fact, accumulated temperature and relative humidity at the body–seat interface have similarly negative effects on prolonged sitting to that of unrelieved pressure. Another interesting finding was the correlation between objective measurement and subjective evaluation; however, the validity of this may be called into question because of the differences in experiment design between studies.