An Exploratory Analysis of the Role of Adipose Characteristics in Fulltime Wheelchair Users’ Pressure Injury History

Frontiers in Bioengineering and Biotechnology, 2021 · DOI: 10.3389/fbioe.2021.753897 · Published: November 29, 2021

Simple Explanation

This study investigates the relationship between different types of fat (adipose tissue) and the history of pressure injuries (PrIs) in full-time wheelchair users. The researchers used MRI scans to examine the fat under the skin (subcutaneous) and within the muscles (intramuscular) of the buttocks of wheelchair users, comparing those with and without a history of PrIs. The study found that participants with a history of PrIs had different characteristics in their subcutaneous fat compared to those without PrIs, specifically darker adipose tissue under the ischium.

Study Duration

Not specified

Participants

43 full-time wheelchair users

Evidence Level

Not specified

Key Findings

1
Participants with a history of PrIs had significantly darker adipose under the ischium than surrounding the ischium compared to participants without a history of PrIs.
2
When individuals with complete fat infiltration were excluded, those with a PrI history had more fat infiltration than those without a PrI history.
3
The presence of spasms was associated with leaner muscle, while more years using a wheelchair were associated with more fat infiltration.

Research Summary

This study explored the relationship between adipose characteristics and pressure injury (PrI) history in full-time wheelchair users using MRI scans to examine subcutaneous and intramuscular fat. The study found that participants with a history of PrIs had significantly different subcutaneous fat characteristics, with darker adipose under the ischium compared to surrounding areas. The research suggests that changes in adipose tissue under the ischial tuberosity are associated with increased biomechanical risk for pressure injury, highlighting the importance of further investigation into adipose's role in PrI etiology.

Practical Implications

Clinical Assessment

Palpation may be augmented with an objective assessment of SubQF adipose quality to understand biomechanical risk and tissue tolerance.

Preventative Intervention

Improving the SubQF quality could be an interventional goal to decrease the biomechanical risk.

Diagnostic Techniques

The study may lead to clinically useful diagnostic techniques that can identify changes in adipose and biomechanical risk to inform early preventative interventions.

Study Limitations

1
The MRI scans used in this study were not optimized for studying intramuscular or SubQF adipose.
2
There was a difference in the years of wheelchair use between the two groups that may have impacted IMAT analysis.
3
Additional factors and comorbidities, such as chemotherapy or diabetes, were also not analyzed but may have influenced IMAT.

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