Physiological measurements of tissue health; implications for clinical practice

Pressure mapping alone insufficiently describes tissue health. Comprehensive, quantitative non invasive assessment is crucial. Interface pressures (IPs) and transcutaneous blood gas levels [transcutaneous tissue oxygen (T c PO 2 )] were simultaneously assessed over both ischia and the sacrum to investigate the hypotheses: (i) tissue oxygenation decreases with sustained applied pressure; (ii) tissue oxygen and IP are inversely correlated in loaded soft tissues; (iii) multisite assessments are unnecessary because healthy individuals are symmetrical. Measurements were taken at 5‐minute intervals for 20 minutes in both sitting and supine lying for a cohort of 20 able‐bodied adults. There were no statistically significant changes over time for either variable in 96% of timepoint comparisons. Specifically, no significant differences were seen between 10 and 20 minutes in either position. These findings imply that a 10‐minute assessment can reliably indicate tissue health and that tissue may adapt to applied load over time. No statistically significant correlations between T c PO 2 and IP were observed. However, the left and right ischia were significantly different for both variables in supine lying ( P < 0·001) and for sitting IP ( P < 0·010). Thus, even in this healthy cohort, postural symmetry was not observed and should not be assumed for other populations with restricted mobility. If a multisite technique cannot be used, repeated tissue health assessments must use the same anatomic location.