An investigation into interface pressure (IP) risk of healthy volunteers on modern medical imaging and radiotherapy tables

• Main Author: Angmorterh, S. K.
• Published: University of Salford 2016
• Subjects: 615.8
• Online Access: http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.703340

Background and Rationale: Pressure ulcers (PUs) present significant threats to patients and cost billions of total healthcare expenditure. In radiography/radiotherapy, a potential for high interface pressure (IP) on radiography/radiotherapy tables may exist, however no study has investigated this to an acceptable scientific level. Thesis aims: This thesis involved two-phases. The primary aim of phase one was to investigate whether IP risks exist on radiography/radiotherapy tables. The secondary aim was to assess the perception of pain and comfort on radiography/radiotherapy tables. The aim of phase two was to determine the impact of pressure relieving interventions on IP at jeopardy areas. Method and results: In the first phase, an Xsensor pressure mapping system was used to measure IP of jeopardy areas in healthy volunteers (26 females, 23 males; aged 18-59 (mean=34.6±10.5)) on three radiography/radiotherapy surfaces, after which they completed a pain and comfort questionnaire. ANOVA identified statistically significant differences in the mean IP for head, sacrum, and heels across the three surfaces (p≤0.001). Results indicated high IP values for head (75.9±6.9mmHg) on the radiotherapy table. This high IP could induce tissue breakdown, thereby increasing the risk of developing PUs in at risk populations. Volunteers experienced most pain whilst lying on the radiotherapy table. In phase two, a thin gel intervention with low radiation attenuation, which also has no impact on image quality, was assessed to reduce IP risks identified for the head. Pressure mapping was conducted on 20 healthy volunteers (14 males (70%) and six females (30%)); aged 25-53 years (mean=34.4±7.0). Paired-samples t-test indicated a statistically significant difference in the mean IP for the head with and without the intervention; both comparisons recorded mean IP values of 62.4±6.1 and 83.9±8.1 mmHg respectively, p≤0.001. Similarly, there was statistically significant difference in the PPI of the head with and without the intervention (mean=159.8±26.8, and mean=205.1±28.2mmHg respectively; p≤0.001). Conclusion: IP risk exists for the head on radiotherapy tables. This could induce tissue injury in patients accessing prolonged interventional radiography and radiotherapy procedures for the head. A thin gel silicone intervention can reduce this risk. Further research is needed to assess its impact in at risk populations.