There are many situations where the skin and underlying soft tissues are compromised\nby mechanical loading in the form or pressure, or pressure in combination\nwith shear. If sustained, this can lead to damage in the tissues particularly adjacent to\nbony prominences, resulting in chronic wounds. An array of bioengineering technologies\nhave been adopted to assess the integrity of loaded soft tissues. This paper aims\nto review these approaches for the quantification, simulation and early detection of\nmechanically-induced skin damage. The review considers different measurements at\nthe interface between the skin and support surface/medical device, involving pressure,\nshear, friction and the local microclimate. The potential of the techniques to monitor\nthe physiological response of the skin to these external stimuli including biophysical\nmeasurement devices and sampling of biofluids are critically analysed. In addition, it\nincludes an analysis of medical imaging technologies and computational modelling\nto provide a means by which tissue deformation can be quantified and thresholds for\ntissue damage defined. Bioengineering measurement and imaging technologies have\nprovided an insight into the temporal status of loaded skin. Despite the advances in\ntechnology, to date, the translation to clinical tools which are robust and cost effective\nhas been limited. There is a need to adapt existing technologies and simulation\nplatforms to enable patients, carers and clinicians to employ appropriate intervention\nstrategies to minimise soft tissue damage.
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