Real-Time Continuous Monitoring of Sub-Dermal Tissue Stresses Under the Ischial Tuberosities in Individuals With Spinal Cord Injury

Individuals with a spinal cord injury (SCI) are susceptible to deep tissue injury (DTI) which is a pressure-related-necrosis that onsets in the gluteus muscles under the ischial tuberosities (IT). The condition may exacerbate to widespread tissue necrosis and sepsis [1], but early detection is currently not feasible because the injury starts and progresses under intact skin. In SCI patients, local elevated mechanical strains and stresses are formed around the IT, and are not relieved through motion [2]. The excessive tissue strains and stresses, combined with ischemia and hindered diffusion, induce and promote muscle cell death [3]. Recently, we developed a real-time, patient-specific finite element (FE) modeling method and experimental system with a clinical orientation of providing early detection of sub-dermal mechanical conditions that potentially lead to DTI. We presented this system and initial data from healthy adults during the 2006 Summer Bioengineering Conference [4]. Herein, we provide, for the first time, data from trials in an individual with SCI monitored by the system, which indicates that mechanical conditions in gluteus muscles of SCI patients are substantially distinct from those of control subjects.