The biomechanical efficacy of a hydrogel-based dressing in preventing facial medical device-related pressure ulcers

Personalized Nasal Protective Devices: Importance and Perspectives

Nowadays, in addition to diseases caused by environmental pollution, the importance of personalized protection against various infectious agents has become of paramount importance. Besides medicine, several technical and technological studies have been carried out to develop suitable devices. One such revolutionary solution is the use of personalized nasal filters, which allow our body to defend itself more effectively against external environmental damage and pathogens. These filters are small devices that are placed in the nose and specifically filter the inhaled environmental contaminants, allergens, and microorganisms according to individual needs. These devices not only play a key role in maintaining our health but also contribute to environmental protection, reducing the inhalation of pollutants and their harmful impact on the natural environment. Another advantage of personalized filters is that they also provide an opportunity to strengthen our individual immune systems. The use of personalized filters allows medicine to provide optimized protection for everyone, focusing on individual genetic and immunological conditions. The momentum behind the development and research of personalized nasal filters has reached astonishing proportions today. Nowadays, many research groups and medical institutions are working to create new materials, nanotechnologies, and bioinformatics solutions in order to create even more effective personalized nasal filters that can also be shaped easily and safely. Considering the needs of the users is at least as important during development as the efficiency of the device. These two properties together determine the success of the product. Industry research focuses not only on improving the efficiency of devices, but also on making them more responsive to user needs, comfort, and portability. Based on all this, it can be concluded that personalized nasal filters can be a promising and innovative solution for protection against environmental pollutants and pathogens. Through a commitment to the research and development of technology, the long-term impact of such devices on our health and the environment can be significant, contributing to improving people's quality of life and creating a sustainable future. With unique solutions and continuous research, we give hope that in the future, despite the environmental challenges, we can enjoy the protection of our health with even more efficient and sophisticated devices.

Perspectives on recent advancements in energy harvesting, sensing and bio-medical applications of piezoelectric gels

The development of next-generation bioelectronics, as well as the powering of consumer and medical devices, require power sources that are soft, flexible, extensible, and even biocompatible. Traditional energy storage devices (typically, batteries and supercapacitors) are rigid, unrecyclable, offer short-lifetime, contain hazardous chemicals and possess poor biocompatibility, hindering their utilization in wearable electronics. Therefore, there is a genuine unmet need for a new generation of innovative energy-harvesting materials that are soft, flexible, bio-compatible, and bio-degradable. Piezoelectric gels or PiezoGels are a smart crystalline form of gels with polar ordered structures that belongs to the broader family of piezoelectric material, which generate electricity in response to mechanical stress or deformation. Given that PiezoGels are structurally similar to hydrogels, they offer several advantages including intrinsic chirality, crystallinity, degree of ordered structures, mechanical flexibility, biocompatibility, and biodegradability, emphasizing their potential applications ranging from power generation to bio-medical applications. Herein, we describe recent examples of new functional PiezoGel materials employed for energy harvesting, sensing, and wound dressing applications. First, this review focuses on the principles of piezoelectric generators (PEGs) and the advantages of using hydrogels as PiezoGels in energy and biomedical applications. Next, we provide a detailed discussion on the preparation, functionalization, and fabrication of PiezoGel-PEGs (P-PEGs) for the applications of energy harvesting, sensing and wound healing/dressing. Finally, this review concludes with a discussion of the current challenges and future directions of P-PEGs.

Definition and evaluation of a finite element model of the human heel for diabetic foot ulcer prevention under shearing loads

Diabetic foot ulcers are triggered by mechanical loadings applied to the surface of the plantar skin. Strain is considered to play a crucial role in relation to ulcer etiology and can be assessed by Finite Element (FE) modeling. A difficulty in the generation of these models is the choice of the soft tissue material properties. In the literature, many studies attempt to model the behavior of the heel soft tissues by implementing constitutive laws that can differ significantly in terms of mechanical response. Moreover, current FE models lack of proper evaluation techniques that could estimate their ability to simulate realistic strains. In this article, we propose and evaluate a FE model of the human heel for diabetic foot ulcer prevention. Soft tissue constitutive laws are defined through the fitting of experimental stretch-stress curves published in the literature. The model is then evaluated through Digital Volume Correlation (DVC) based on non-rigid 3D Magnetic Resonance Image Registration. The results from FE analysis and DVC show similar strain locations in the fat pad and strain intensities according to the type of applied loads. For additional comparisons, different sets of constitutive models published in the literature are applied into the proposed FE mesh and simulated with the same boundary conditions. In this case, the results in terms of strains show great diversity in locations and intensities, suggesting that more research should be developed to gain insight into the mechanical properties of these tissues.

Graded stiffness offloading insoles better redistribute heel plantar pressure to protect the diabetic neuropathic foot

BACKGROUND

Diabetic heel ulceration is a common, detrimental, and costly complication of diabetes. This study investigates a novel "graded-stiffness" offloading method, which consists of a heel support with increasing levels of stiffness materials to better redistribute plantar pressure for heel ulcer prevention and treatment.

RESEARCH QUESTION

Is the novel "graded-stiffness" solution better able to redistribute heel pressure and reduce focal stress concentration areas of the heel?

METHODS

Twenty healthy young men walked with four, 3D-printed, insole configurations. The configurations included the "graded-stiffness" insoles with and without an offloading hole under the heel tissue at risk for ulcerations and two conventional offloading supports of flat insoles with no offloading and simple holed offloading insoles. In-shoe plantar pressure was measured using the Pedar-X system. Peak pressure and pressure dose were measured at three heel regions: offloaded region, perimeter of offloaded region, and periphery region.

RESULTS

The simple offloading configuration reduced pressure at the offloaded region; however, pressure at the perimeter of the offloading region significantly increased. With respect to ANOVA, the "graded-stiffness" offloading configurations were more effective than existing tested solutions in reducing and redistributing heel peak pressure and pressure dose, considering all heel regions.

SIGNIFICANCE

The "graded-stiffness" offloading solution demonstrated a novel flexible and customized solution that can be manufactured on-demand through a precise selection of the graded-stiffness offloading location and material properties to fit the shape and size of the ulcer. This study is a follow-up in-vivo pilot study, in a healthy population group, to our previous computation modeling work that reported the efficiency of the "graded-stiffness" configuration, and which emphasizes its potential for streamlining and optimizing the prevention and treatment of diabetic heel ulcers.

Effect of Algoplaque Hydrocolloid Dressing Combined with Nanosilver Antibacterial Gel under Predictive Nursing in the Treatment of Medical Device-Related Pressure Injury

It was aimed at the clinical value of predictive nursing and Algoplaque hydrocolloid dressing (AHD) combined with nanosilver antibacterial gel in treating medical device-related pressure injury (MDRPI). 100 patients, who underwent surgery in Chongqing Qijiang District People's Hospital from February 2019 to February 2020, were selected as the research objects and were randomly divided into the experimental group (50 cases) and the control group (50 cases). For the characterization test, a nanosilver antibacterial gel was created first. Patients in both groups received predictive nursing, but those in the experimental group received AHD and nanosilver antibacterial gel, and those in the control group received gauzes. MDRPI incidence, pressed skin injury severity, comfort level, clothing changes, nursing satisfaction, and other factors were all compared. The particle size of the nanosilver gel was 45-85 nm, with a relatively homogeneous distribution with the medium size, according to the findings. The incidence of MDRPI in the experimental group was lower than that in the control group significantly (6% vs. 30%, P < 0.05). The degree of injury of pressured skin in the experimental group was milder than that in the control group (P < 0.05), the degree of comfort and nursing satisfaction was higher in the experimental group than in the control group (P < 0.05), and dressing change count was lower than that in the control group (P < 0.05). In the treatment of MDRPI, predictive nursing and AHD using nanosilver antibacterial gel showed high clinical application value.

Alternatives and preferences for materials in use for pressure ulcer prevention: An experiment-reinforced literature review

Alleviation of localised, sustained tissue loads and microclimate management are the most critical performance criteria for materials in use for pressure ulcer prevention, such as in prophylactic dressings, padding or cushioning. These material performance criteria can be evaluated by calculating the extents of matching between the material stiffness (elastic modulus) and the thermal conductivity of the protective dressing, padding or cushioning with the corresponding properties of native skin, separately or in combination. Based on these bioengineering performance criteria, hydrocolloids, which are commonly used for prophylaxis of medical device-related pressure ulcers, exhibit poor stiffness matching with skin. In addition, there is remarkable variability in the modulus and thermal conductivity matching levels of different material types used for pressure ulcer prevention, however, it appears that among the materials tested, hydrogels provide the optimal matching with skin, followed by gels and silicone foams. The stiffness matching for hydrocolloids appears to be inferior even to that of gauze. This article provides quantitative performance criteria and metrics for these evaluations, and grades commonly used material types to biomechanically guide clinicians and industry with regards to the selection of dressings for pressure ulcer prevention, both due to bodyweight forces and as a result of applied medical devices.

The biomechanical efficacy of a dressing with a soft cellulose fluff core in protecting prone surgical patients from chest injuries on the operating table

Pressure ulcers are soft‐tissue damage associated with tissue exposure to sustained deformations and stress concentrations. In patients who are proned for ventilation or surgery, such damage may occur in the superficial chest tissues that are compressed between the rib cage and the support surface. Prophylactic dressings have been previously proven as generally effective for pressure ulcer prevention. In this study, our goal was to develop a novel computational modelling framework to investigate the biomechanical efficacy of a dressing with a soft cellulose fluff core in protecting proned surgical patients from chest pressure ulcers occurring on the operating table, due to body fixation by the Relton‐Hall frame. We compared the levels of mechanical compressive stresses developing in the soft chest tissues, above the sternum and ribs, due to the trunk weight, whilst the body is supported by the Relton‐Hall frame pads, with versus without the prophylactically applied bilateral dressings. The protective efficacy index for the extremely high stresses, above the 95th‐percentile, were 40.5%, 25.6% and 24.2% for skin, adipose and muscle, respectively, indicating that the dressings dispersed elevated soft‐tissue stresses. The current results provide additional support for using soft cellulose fluff core dressings for pressure ulcer prophylaxis, including during surgery.