Swansea University Shows Dimensional Gel Provides Effective Immersion at Pressure Loads above 40kg

Swansea University Shows Dimensional Gel Provides Effective Immersion at Pressure Loads above 40kg

A recent study conducted by Swansea University provides valuable insights into the performance of silicone and gel sheets under various load conditions, offering practical guidance for clinical applications.

The results showed that Gel Ovations Dimensional Gel pads were more compliant than silicone sheets, likely due to their increased thickness and more viscous material properties.

In addition Dimensional Gel outperformed all other sheets tested in the study in terms of providing effective immersion at pressure loads above 40kg, where the other sheets failed.

The Effectiveness of Silicone Gel Sheets in Protecting Bony Landmarks from Pressure Damage

Silicone and gel sheets are widely recognised for their effectiveness in redistributing pressure and preventing skin damage. Their ability to absorb and distribute loads makes them suitable for use in seating solutions and other applications where pressure injury prevention is critical.

The study by researchers Ahmed Daud, Essodeke Karan, and Dr Mark Bowtell at Swansea University aimed to assess the effectiveness of these materials in offloading pressure from bony landmarks.

By conducting controlled experiments, the study explored how thin substrate materials perform under compression, simulating real-world conditions where pressure ulcers commonly develop.

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Methodology

The study employed a compression testing method to evaluate the performance of silicone and gel sheets. The experimental setup included:

• Test Rig and Materials: A custom-built container made from Evazote and 3D-printed PLA held the gel sheets during testing.
• Simulation of Bony Landmarks: A semi-spherical indenter (30mm radius) was used to replicate areas like elbows or ischial tuberosities.
• Load Application: Predetermined forces ranging from 100 N to 500 N (representing approximately 15–70% of typical body weight) were applied using a programmed actuator.

Various substrates of different thicknesses were tested, with immersion displacement measured using calipers. The study also included a comparison of commercially available products, such as Kerrapro, Dermisplus, Gel Ovations, and Action Gel.

Key Findings

1. Thickness Matters:

• Thicker materials like 12mm Kerrapro demonstrated higher immersion levels compared to thinner sheets, such as 3mm Kerrapro.
• The thinner materials plateaued at a maximum immersion depth of 2.3mm, limiting their effectiveness under higher loads.

2. Material Performance:

• Gel Ovations and Action Gel were more compliant than silicone sheets, likely due to their increased thickness and more viscous material properties.
• Action Gel provided effective immersion at lower loads but failed at higher loads (above 40kg).

3. Subtle Compression Differences:

• All materials met the primary goal of preventing bottoming out under expected load conditions.
• Measurement errors may have obscured some subtle variations in stiffness and compliance among the materials.

Conclusions and Implications

The study affirmed the utility of silicone and gel sheets as effective solutions for offloading pressure from bony landmarks. Their performance in redistributing loads without bottoming out supports their inclusion in pressure injury prevention strategies, particularly where limited material thickness is a practical consideration.

Additionally, the research protocol provides a reliable framework for future testing of different materials and configurations. The insights gained from this study can inform the design and clinical application of pressure-relieving products, optimising outcomes for patients at risk of pressure ulcers.

Future Directions

While the study offers a robust starting point, further research is recommended to:

• Examine long-term material durability under repeated loading.
• Explore the effects of combining silicone/gel sheets with other pressure-relieving interventions.
• Investigate the role of material properties like viscosity and compliance in greater detail.

By continuing to refine testing protocols and product designs, healthcare providers can further enhance the efficacy of pressure injury prevention solutions, ultimately improving patient care and outcomes.

Acknowledgments

This study was supported by the Rehabilitation Engineering Unit (Swansea Bay UHB) and collaborators, including the PDR team at Cardiff Metropolitan University and V-Trak Ltd.

References:

1. Agarwal, A., McAnulty, J. F., Schurr, M. J., Murphy, C. J., & Abbott, N. L. (2011, January 1). 8 – Polymeric materials for chronic wound and burn dressings (D. Farrar, Ed.). ScienceDirect; Woodhead Publishing.

2. Sparks, J. L., Vavalle, N. A., Kasting, K. E., Long, B., Tanaka, M. L., Sanger, P. A., Schnell, K., & Conner-Kerr, T. A. (2015). Use of Silicone Materials to Simulate Tissue Biomechanics as Related to Deep Tissue Injury. Advances in Skin & Wound Care, 28(2), 59–68

3. Chen, W., Lu, F., Frew, D. J., & Forrestal, M. J. (2002). Dynamic Compression Testing of Soft Materials. Journal of Applied Mechanics, 69(3), 214–223.

4. Duffy, D. M. (1990). Silicone: a critical review. Advances in Dermatology, 5(2204381), 93–107; discussion 108-9.

Acknowledgements / Collaborators

William Dauncey, Dominic Eggbeer – PDR, Cardiff Met Uni

Russell Penman – V-trak ltd

Design & Manufacturing team, Swansea REU

PUPIS team, Swansea REU