Because of the need for quality dressings for wound care, a pilot study was instigated to investigate the way skin deformation influenced the way dressings were fixed. The wounds studied were both chronic and post operative wounds ranging from pressure ulcers, leg ulcers and post op incision sites. The model reference skin sites that were chosen were at the legs, neck and upper torso of the patients.
Researchers used medical imaging camera and digital surface photogrammetry techniques to map shape information for the various test sites on the neck and legs of the subjects. The subjects were then marked with pens to note grid points on the test skin. Photos were taken with a DSP400 3D medical imaging camera around various grid points on the test subject's skin. The grid points were marked to note movements of the patient from total relaxation to exerting the normal amount of stress and movement that would be typical. Photos were taken with and without dressings being affixed to the grid-marked skin sections. Researchers found the two parameters with the most significant changes noted were skin shear and skin stretch. It was the skin stretch that was studied for the research project.
Software was developed to work with the 3D photos able to analyze and display on a screen the way skin deformed under movement. These results were color-coded on the grid marks and highlighted the regions of the skin that were either stretched or compressed.
The studies noted through the 3D images highlighted the sometimes counter intuitive response the subject's skin showed to movements. For example, in the study of a subject's neck researchers noted that the skin on the central part of the neck stretched but there was a region of the skin that compressed over the shoulder that was orthogonal to the direction of the stretch performed by the subject. These observations noted through the use of the 3D images showed why dressings fixed on certain areas of the body, failed to perform their duty.
The researchers used a multi-camera system to capture the data to define the grid-marked surface of the skin.
The way dressings are applied to wounds can significantly impact its healing and the quality of life for patients. In spite of years of research, the choice of wound dressing and its ultimate performance and impact on the wound remain unclear in some situations. To properly dress a wound, there are many parameters that impact the performance of the dressing – the fixing position of the dressing, shape of the wound and extensibility.
