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Physiological processes of inflammation and edema initiated by sustained mechanical loading in subcutaneous tissues : a scoping review

Nele Van Damme (UGent) , Ann Van Hecke (UGent) , Eline Remue (UGent) , Karen Van den Bussche (UGent) , Zena Moore (UGent) , Amit Gefen, Sofie Verhaeghe (UGent) and Dimitri Beeckman (UGent)
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Organization
Abstract
Deep tissue injuries are pressure ulcers which initiate in the subcutaneous tissues and extend through a bottom-up pathway. Once deep tissue injuries are visual at skin level, serious irreversible tissue damage has already occurred. In pressure ulcer development, inflammation and edema are coupled physiological processes associated with tissue damage arising due to sustained mechanical loading. This study aimed to provide an in-depth overview of the physiological processes of inflammation and edema initiated by sustained mechanical loading in subcutaneous tissues, in the context of pressure ulceration. A scoping review was performed according to the framework by Arksey and O'Malley. The databases MEDLINE, EMBASE, Web of Science, and Scopus, and the reference lists of included studies were searched for in vivo (animal, human), and in vitro studies matching the study objectives (from inception to 28 May 2018). No restrictions for inclusion were applied for study design, setting, participants, and year of publication. A total of 12 studies were included, varying in study design, sample characteristics, amount and duration of mechanical loads that were applied, follow-up time, and assessment methods. Neutrophil infiltration and edema occur in the subcutaneous tissues nearly immediately after the application of load on soft tissues. The amount of neutrophils and edema increase in the first days after the mechanical insult and decrease once healing has been initiated and no supplementary mechanical load was applied. One study indicated that edema may extend up to the level of the dermo-epidermal junction. Further research should focus on how deep tissue inflammation and edema are reflected into unique tissue changes at skin level, and how abnormal inflammatory responses manifest (e.g. when the nervous system is not functioning normally).
Keywords
ISCHEMIA-REPERFUSION INJURY, CELL-DEATH THRESHOLD, PRESSURE ULCERS, MUSCLE DAMAGE, SUBEPIDERMAL MOISTURE, SKELETAL-MUSCLE, DECUBITUS ULCER, DEEP, DEFORMATION, SKIN

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MLA
Van Damme, Nele, et al. “Physiological Processes of Inflammation and Edema Initiated by Sustained Mechanical Loading in Subcutaneous Tissues : A Scoping Review.” WOUND REPAIR AND REGENERATION, 2020.
APA
Van Damme, N., Van Hecke, A., Remue, E., Van den Bussche, K., Moore, Z., Gefen, A., … Beeckman, D. (2020). Physiological processes of inflammation and edema initiated by sustained mechanical loading in subcutaneous tissues : a scoping review. WOUND REPAIR AND REGENERATION.
Chicago author-date
Van Damme, Nele, Ann Van Hecke, Eline Remue, Karen Van den Bussche, Zena Moore, Amit Gefen, Sofie Verhaeghe, and Dimitri Beeckman. 2020. “Physiological Processes of Inflammation and Edema Initiated by Sustained Mechanical Loading in Subcutaneous Tissues : A Scoping Review.” WOUND REPAIR AND REGENERATION.
Chicago author-date (all authors)
Van Damme, Nele, Ann Van Hecke, Eline Remue, Karen Van den Bussche, Zena Moore, Amit Gefen, Sofie Verhaeghe, and Dimitri Beeckman. 2020. “Physiological Processes of Inflammation and Edema Initiated by Sustained Mechanical Loading in Subcutaneous Tissues : A Scoping Review.” WOUND REPAIR AND REGENERATION.
Vancouver
1.
Van Damme N, Van Hecke A, Remue E, Van den Bussche K, Moore Z, Gefen A, et al. Physiological processes of inflammation and edema initiated by sustained mechanical loading in subcutaneous tissues : a scoping review. WOUND REPAIR AND REGENERATION. 2020;
IEEE
[1]
N. Van Damme et al., “Physiological processes of inflammation and edema initiated by sustained mechanical loading in subcutaneous tissues : a scoping review,” WOUND REPAIR AND REGENERATION, 2020.
@article{8634250,
  abstract     = {Deep tissue injuries are pressure ulcers which initiate in the subcutaneous tissues and extend through a bottom-up pathway. Once deep tissue injuries are visual at skin level, serious irreversible tissue damage has already occurred. In pressure ulcer development, inflammation and edema are coupled physiological processes associated with tissue damage arising due to sustained mechanical loading. This study aimed to provide an in-depth overview of the physiological processes of inflammation and edema initiated by sustained mechanical loading in subcutaneous tissues, in the context of pressure ulceration. A scoping review was performed according to the framework by Arksey and O'Malley. The databases MEDLINE, EMBASE, Web of Science, and Scopus, and the reference lists of included studies were searched for in vivo (animal, human), and in vitro studies matching the study objectives (from inception to 28 May 2018). No restrictions for inclusion were applied for study design, setting, participants, and year of publication. A total of 12 studies were included, varying in study design, sample characteristics, amount and duration of mechanical loads that were applied, follow-up time, and assessment methods. Neutrophil infiltration and edema occur in the subcutaneous tissues nearly immediately after the application of load on soft tissues. The amount of neutrophils and edema increase in the first days after the mechanical insult and decrease once healing has been initiated and no supplementary mechanical load was applied. One study indicated that edema may extend up to the level of the dermo-epidermal junction. Further research should focus on how deep tissue inflammation and edema are reflected into unique tissue changes at skin level, and how abnormal inflammatory responses manifest (e.g. when the nervous system is not functioning normally).},
  author       = {Van Damme, Nele and Van Hecke, Ann and Remue, Eline and Van den Bussche, Karen and Moore, Zena and Gefen, Amit and Verhaeghe, Sofie and Beeckman, Dimitri},
  issn         = {1067-1927},
  journal      = {WOUND REPAIR AND REGENERATION},
  keywords     = {ISCHEMIA-REPERFUSION INJURY,CELL-DEATH THRESHOLD,PRESSURE ULCERS,MUSCLE DAMAGE,SUBEPIDERMAL MOISTURE,SKELETAL-MUSCLE,DECUBITUS ULCER,DEEP,DEFORMATION,SKIN},
  language     = {eng},
  title        = {Physiological processes of inflammation and edema initiated by sustained mechanical loading in subcutaneous tissues : a scoping review},
  url          = {http://dx.doi.org/10.1111/wrr.12777},
  year         = {2020},
}

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