Effects of alternating pressure patterns on sacral skin blood flow responses in people with spinal cord injury

Int Wound J, 2024 · DOI: 10.1111/iwj.14792 · Published: February 2, 2024

Spinal Cord Injury Cardiovascular Science Dermatology

Simple Explanation

Alternating pressure support surfaces (APSS) are frequently used to manage pressure injuries in individuals with spinal cord injuries (SCI). However, the effectiveness of APSS can vary depending on how they are configured. This study examined how different pressure settings and cycle times of alternating pressure affect blood flow in the sacral skin of people with SCI. The study found that the pressure amplitude of alternating pressure significantly affects sacral skin blood flow responses. An appropriate configuration of alternating pressure is needed to effectively increase skin blood flow and tissue viability in individuals with SCI.

Study Duration

Not specified

Participants

10 individuals with SCI

Evidence Level

Not specified

Key Findings

1
During the high-pressure phase, there was a significant difference between the 75/5 and 65/15 mmHg protocols.
2
During the low-pressure phase, there was a significant difference between the 75/5 and 65/15 mmHg protocols.
3
There were no differences between cycle periods in skin blood flow responses.

Research Summary

This study investigates the impact of varying pressure amplitudes and cycle-time periods of alternating pressure (AP) on sacral skin blood flow in individuals with spinal cord injury (SCI). The results indicated significant differences in skin blood flow between the two pressure amplitude protocols during both high-pressure and low-pressure phases of alternating pressure. The study concludes that the pressure amplitude of 75/5 mmHg and a 5-min cycle-time period resulted in larger mean skin blood flow compared to 65/15 mmHg and a 2.5-min cycle-time period.

Practical Implications

Optimizing APSS Configuration

The findings underscore the importance of tailoring pressure amplitudes and cycle-time periods to optimize blood flow, crucial for preventing pressure ulcers among vulnerable populations, including wheelchair users with spinal cord injury.

Clinical Application Adherence

Translating these research outcomes into clinical applications necessitates adherence to robust safety standards and current guidelines, ensuring designed products meet stringent safety criteria.

Integration into Guidelines

Integrate these insights into existing guidelines governing pressure ulcer prevention strategies, enhancing the efficacy of clinical interventions and advancing the field of pressure ulcer prevention in clinical practice.

Study Limitations

1
Tissue viability is checked only at the skin level of the sacrum and not at a deeper, skeletal muscle level.
2
The sample population included an unequal ratio of both people with complete and incomplete levels of spinal cord injury.
3
The study was completed with a small sample size of 10 participants.

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