Biomechanics of pressure ulcer in body tissues interacting with external forces during locomotion

Arthur F.T. Mak, Ming Zhang, Wing Cheung Eric Tam

Research output: Journal article publicationReview articleAcademic researchpeer-review

80 Citations (Scopus)


Forces acting on the body via various external surfaces during locomotion are needed to Support the body under gravity, control posture, and overcome inertia. Examples include the forces acting on the body via the seating surfaces during wheelchair propulsion, the forces acting on the plantar foot tissues via the insole during gait, and the forces acting on the residual-limb tissues via the prosthetic socket during various movement activities. Excessive exposure to unwarranted stresses at the body-support interfaces could lead to tissue breakdowns commonly known as pressure ulcers, often presented as deep-tissue injuries around bony prominences or as surface damage on the skin. In this article, we review the literature that describes how the involved tissues respond to epidermal loading, taking into account both experimental and computational findings from in vivo and in vitro studies. In particular, we discuss related literature about internal tissue deformation and stresses, microcirculatory responses, and histological, cellular, and molecular observations.
Original languageEnglish
Pages (from-to)29-53
Number of pages25
JournalAnnual Review of Biomedical Engineering
Publication statusPublished - 15 Aug 2010


  • deep-tissue injury
  • ischemic reperfusion
  • pressure ulcer
  • rehabilitation engineering
  • skin
  • tissue biomechanics

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Biomedical Engineering


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