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Early detection for pressure ulcers in people with mental illness

Developing early detection methods to assess the risk of pressure ulcers in individuals with mental illness

Led by Professor Dan Bader, University of Southampton/MDVSN Plus, in association with the University of Manchester

Pressure ulcers (PU) can develop if an individual spends prolonged periods sitting or lying in one position. Indeed, people with mental health conditions are at high risk, with dementia patients exhibiting a particularly high prevalence rate [Jaul et al., 2017]. Causes of this enhanced risk include inadequate repositioning, poor diet and dehydration, medication and communication. PU prevention would lead to an improved quality of life in the dementia population and a reduced medical burden [Jaul et al., 2017]. This feasibility study aims to develop early screening methods to evaluate PU risk in this vulnerable population.

Two technologies will be employed to assess risk, namely:

  1. Actimetry monitoring of posture and mobility
  2. Sampling of selective biomarkers indicative of skin status.

Several studies have used accelerometer technologies to monitor patients with dementia, for example, to examine the temporal profile and orientation of an individual’s posture]. Biomarkers, collected in sebum from the skin surface, can also be sampled to interrogate the skin response to prolonged loading, using a non-invasive technique to measure pro-inflammatory cytokines. This approach, adopted by the applicants to examine various medical devices and the effects of shear forces, revealed that loading produced an up-regulation of cytokines, notably IL-1α. This provides the motivation for the current work to study both an elderly able-bodied cohort and a small cohort of individuals at an inherently high risk of developing PUs. This approach offers the potential to improve the clinical management of vulnerable individuals with mental illness.

Presentation from the Stage 1 Update Workshop, November 2017