Monitoring and alleviating the effects of pressure related injuries for spinal surgery–a need for improvement?

The development of pressure injuries (PIs) is a common complication arising during surgery. Monitoring and alleviating PIs is currently not possible during lengthy spinal and orthopaedic surgeries, especially if a patient requires x-rays. We interviewed surgical staff to gain an understanding of attitudes regarding current methods and approaches for the management of PIs to allow the development of new devices based on staff feedback. Interviewees provided insights regarding the possible design of a new device used to monitor and alleviate pressure injuries in a surgical environment. From the interviews we derived key themes, including current devices/systems, current risk assessment/scales, and design considerations. As a result, we identified critical design requirements and an appropriate product design specification. Background: Complications can arise when perioperative staff are monitoring a patient’s health status during surgery, including the development of pressure injuries (PIs). It is important to reduce the incidence rates of developing PIs intraoperatively, and thereby mitigate both increased costs and negative impacts to patients and care providers. Current pressure relief supports offer limited monitoring abilities throughout the perioperative environment. Aim: The aim of this study is to establish clear design requirements and a product design specification that enables a new closed-loop product solution to be developed with real-time pressure monitoring during surgery. Method: We conducted semi-structured interviews with nine different clinical staff members involved in the perioperative environment. We conducted the interviews over a two-week period with two major teaching hospitals within the East Midlands, UK. Questions focused on healthcare professionals’ perceptions of current methods and their approaches to managing PIs. We recorded and transcribed participants’ data using NVivo software. Conclusion: The interview data identified a need for an improved method to manage and monitor PIs. We established that the incorporation of live feedback to reduce the prevalence of PIs is a critical design priority. Based on the interviews, we developed design criteria and a product design specification (PDS). Interview transcripts suggest a new device design should focus on a novel radiolucent pressure redistribution solution capable of reducing PIs intraoperatively while incorporating live feedback

Smart textile pressure sensor matrices - investigation of sensor characteristics for use in the surgical environment

This paper presents research on flat textile pressure sensor characteristics that are advantageous for use in the surgical environment. Eight, 4 by 4 textile pressure matrices were subjected to sensor error testing to evaluate the sensor output differences on foam vs. no foam. The pressure matrices were tested using a compression tester while monitoring the voltage output. The errors analysed included the span, sensitivity, and nonlinearity. The findings show that for use in the surgical environment, prototypes two and three demonstrate better performances in the tests on foam, and both prototypes exhibit properties that are more suited for the surgical environment and warrant further prototype development

Mapping the human genetic architecture of COVID-19

The genetic make-up of an individual contributes to the susceptibility and response to viral infection. Although environmental, clinical and social factors have a role in the chance of exposure to SARS-CoV-2 and the severity of COVID-191,2, host genetics may also be important. Identifying host-specific genetic factors may reveal biological mechanisms of therapeutic relevance and clarify causal relationships of modifiable environmental risk factors for SARS-CoV-2 infection and outcomes. We formed a global network of researchers to investigate the role of human genetics in SARS-CoV-2 infection and COVID-19 severity. Here we describe the results of three genome-wide association meta-analyses that consist of up to 49,562 patients with COVID-19 from 46 studies across 19 countries. We report 13 genome-wide significant loci that are associated with SARS-CoV-2 infection or severe manifestations of COVID-19. Several of these loci correspond to previously documented associations to lung or autoimmune and inflammatory diseases3,4,5,6,7. They also represent potentially actionable mechanisms in response to infection. Mendelian randomization analyses support a causal role for smoking and body-mass index for severe COVID-19 although not for type II diabetes. The identification of novel host genetic factors associated with COVID-19 was made possible by the community of human genetics researchers coming together to prioritize the sharing of data, results, resources and analytical frameworks. This working model of international collaboration underscores what is possible for future genetic discoveries in emerging pandemics, or indeed for any complex human disease