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Individual Cooling and Compression System for Accelerated Swelling Reduction on Fractures

8 pagesPublished: June 13, 2017

Abstract

After a fracture injury a swelling of the skin soft tissue results which prevents an early operation. In order to shorten the waiting time until the decrease of the swelling, the metabolism-reducing effect of mild local hypothermia and the swelling-reducing effect of compression therapy should be used in a device anatomically adjusted to the patient. For the best possible treatment, a regulation of the cooling and compression parameters should be carried out by means of sensor technology in order to allow an adaptation to the individual patient.

After a fracture injury a swelling of the skin soft tissue results which prevents an early operation. In order to shorten the waiting time until the decrease of the swelling, the metabolism-reducing effect of mild local hypothermia and the swelling-reducing effect of compression therapy should be used in a device anatomically adjusted to the patient. For the best possible treatment, a regulation of the cooling and compression parameters should be carried out by means of sensor technology in order to allow an adaptation to the individual patient.
Based on medical studies, parameter areas relevant to patients could be determined. These were implemented in first functional models for a cooling system and a compression system. Anatomically adapted cooling and pressure chambers allow a good physical coupling of the system to humans. The first test results, considering the heat emission and the skin elasticity properties of the human body, show that both rapid cooling can be achieved in a range of between 17 and 20°C of skin temperature within 4 min, and that under a pressure effect of between 10 and 20 kPa in the pressure chambers a pressure on the human tissue can be produced up to 15 kPa. The cooling system based on Peltier elements is capable of transporting a heat flow up to 10 W. The quiet, maintenance-free Peltier elements also increase the patient's acceptance. In the pressure chambers, a temporally overlapping generation of pressure pulses can imitate the process of natural walking by the effect of muscle pumps and contribute to a technical lymphatic drainage. By detecting the inflammation area with the aid of netlike-arranged temperature sensors and measuring the internal pressure of the pressure chambers in the case of a swelling tissue, cooling can be carried out at a determined point and the occurrence of, for example, a compartment syndrome can be prevented by regulating the pressure.
At present still ongoing, promising developments of models for the consideration of the temperature distribution and pressure differences in the cardiovascular system should enable a determination of optimized cooling and pressure curves adapted to the individual human. In this way, the best possible control circuits should be identified using medical expert knowledge.

Keyphrases: compartment syndrome, cooling and pressure curves, physiological simulation

In: Klaus Radermacher and Ferdinando Rodriguez Y Baena (editors). CAOS 2017. 17th Annual Meeting of the International Society for Computer Assisted Orthopaedic Surgery, vol 1, pages 74--81

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