Intermittent catheterization (IC) utilizing conventional eyelets catheters (CECs) for bladder drainage has long been the standard of care. However, when the tissue of the lower urinary tract comes in close proximity to the eyelets, mucosal suction often occurs, resulting in microtrauma. This study investigates the impact of replacing conventional eyelets with a drainage zone featuring multiple micro-holes, distributing pressure over a larger area. Lower pressures limit the suction of surrounding tissue into these micro-holes, significantly reducing tissue microtrauma. Using an ex vivo model replicating the intra-abdominal pressure conditions of the bladder, the intra-catheter pressure was measured during drainage. When mucosal suction occurred, intra-catheter images were recorded. Subsequently affected tissue samples were investigated histologically. The negative pressure peaks caused by mucosal suction were found to be very high for the CECs, leading to exfoliation of the bladder urothelium and breakage of the urothelial barrier. However, a micro-hole zone catheter (MHZC) with a multi-eyelet drainage zone showed significantly lower pressure peaks, with over 4 times lower peak intensity, thus inducing far less extensive microtraumas. Limiting or even eliminating mucosal suction and resulting tissue microtrauma may contribute to safer catheterizations in vivo and increased patient comfort and compliance.

This study aims at investigating the effects of three different wheelchair cushion technologies at the patient-wheelchair interface. To this end, eight participants were recruited to remain in an unrelieved seated position on a wheelchair successively equipped with three different cushions (foam, air-cell-based and gel), for a duration of 45 min. Interface pressure, temperature (measured with infrared thermography) and relative humidity were measured at the seat interface, at different timestamps. Experimental results show that foam cushion is significantly more efficient in reducing contact peak pressure (p < .01), while the gel cushion displays higher heat evacuation capabilities. In terms of relative humidity, no significant difference is observed among the three technologies (p > .29): all of them evacuate around only 10% of the total humidity compared to the reference situation (i.e., without cushion). Besides, a complementary numerical simulation corresponding to the steady state of the patient-wheelchair structure clearly highlights the temperature volume field at the underside of the seat, which acts like a thermal barrier and contributes to heat accumulation. Besides, an air flow at the underside of the chair in motion is shown to significantly reduce heat accumulation.