Tension pneumothorax, a major preventable cause of battlefield death, often arises from chest trauma and is treated by needle decompression to release trapped air from the pleural cavity. Surgical simulation mannequins are often employed to train medical personnel to perform this procedure properly. Accurate reproduction of the mechanical behavior of the parietal pleura, especially in response to needle penetration, is essential to maximize the fidelity of these surgical simulators. To date, however, the design of pleura-simulating material has been largely empirical and based on subjective practitioner feel rather than on the tissue properties, which have remained unknown. In this study, we performed uniaxial extension tests on samples of cadaveric human parietal pleura. We found that the pleura was highly nonlinear and mildly anisotropic, being roughly twice as stiff in the direction parallel to the ribs vs. perpendicular to the ribs (large-strain modulus = 20.44 vs. 11.49 MPa). We also did not find significant correlations for most pleural properties with age or BMI, but it must be recognized that the age range (59 ± 9.5 yrs) and BMI range (31 ± 5.3) of the donors in our study was not what one might expect from combatants, and there could be differences for younger, lighter individuals. We found a significantly higher low-strain modulus in the diabetic donors (0.213 vs. 0.100 MPa), consistent with the general tendency of tissue to stiffen in diabetes. The nonlinearity and tensile strength should be considered in material design and selection for future surgical simulators.
|Original language||English (US)|
|Number of pages||6|
|Journal||Journal of the Mechanical Behavior of Biomedical Materials|
|State||Published - Nov 2017|
Bibliographical noteFunding Information:
The authors thank the anonymous donors whose tissue was used in this study. Research was sponsored in part by the Army Research Laboratory and was accomplished under Cooperative Agreement Number W911NF-14-2-0035. The views and conclusions contained in this document are those of the authors and should not be interpreted as representing the official policies, either expressed or implied, of the Army Research Laboratory or the U.S. Government. The U.S. Government is authorized to reproduce and distribute reprints for Government purposes notwithstanding any copyright notation herein.
- Parietal pleura
- Tension pneumothorax
- Uniaxial extension