Differential Response of Skin and Muscle in the Experimental Production of Pressure Sores

Publisher Website
Google Scholar
Abstract
An experimental model was developed to determine the effects of pressure on skin and muscle in rats. A pressure-time regimen that consistently produced cutaneous ulceration (100%) over a bony pressure point produced no ulceration in skin in a location where muscle separated skin and bone. When pressure was applied to skin over a transposed muscle flap and bone, a reduction of the incidence of ulceration (69%) was noted, as compared to the corresponding side without a muscle flap between skin and bone (100% ulceration). Histologic studied of skin and muscle biopsies demonstrated epidermal breakdown, increased cellularity and muscle fiber necrosis when cutaneous ulceration occurred. In the animals without ulceration, where normal muscle or a muscle flap was interposed between skin and bone, there were significant areas of muscle necrosis in almost every case. Although the increased mass of muscle under skin can diffuse pressure and lessen incidence of ulceration, the extremely high incidence of muscle necrosis in response to pressure, despite absence of skin ulceration, suggests that muscle is an unsuitable coverage for a pressure-bearing area.