{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T05:33:29Z","timestamp":1790487209737,"version":"4.1.0"},"reference-count":26,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2017,11,27]],"date-time":"2017-11-27T00:00:00Z","timestamp":1511740800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"M\u00f6lnlycke Health Care, Gothenburg, Sweden"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["International Wound Journal"],"published-print":{"date-parts":[[2018,4]]},"abstract":"<jats:p>Patients who are stationary endure prolonged soft tissue distortions and deformations at contact areas between their body and the support surface, which may lead to the onset of pressure ulcers (PUs) over time. A novel technology for patient positioning employs innovation in materials science, specifically viscoelastic materials with shape memory properties that compose the Z\u2010Flo\u2122 head positioner (M\u00f6lnlycke Health Care, Gothenburg, Sweden). Head positioners are generally known to reduce the occurrence of PUs in scalp tissues and the ears, but quantitative assessments of their biomechanical efficacy are missing in the literature. To determine potential differences in mechanical loads formed in the soft tissues of the back of the head while in contact with 2 head positioner types, Z\u2010Flo vs flat medical foam, we developed 2 comparable finite element model configurations, both including the same 3\u2010dimensional adult head. For both model variants, stresses in skin and fat peaked at the occiput. The skin at the back of the resting head is subjected to greater stress values with respect to fat; however, the Z\u2010Flo positioner reduced the exposure of both skin and fat tissues to elevated stresses considerably (by a factor of 3) compared to the medical foam support. We found the Z\u2010Flo device effective in reducing tissue loads at the surface of the head as well as internally in scalp tissues, with a particular strength in reducing internal tissue shear. The Z\u2010Flo device achieves this protective quality through highly effective immersion and envelopment of the back of the head, generated in the process of manual moulding of the device in preparation for use. Additional protection is achieved through the viscoelastic response of the filling material of this positioner, which relaxes promptly and considerably under the weight of the head (by more than 2\u2010fold within approximately 1 s) as opposed to the elastic recoil of the foam that pushes back on scalp tissues.<\/jats:p>","DOI":"10.1111\/iwj.12857","type":"journal-article","created":{"date-parts":[[2017,11,27]],"date-time":"2017-11-27T06:30:52Z","timestamp":1511764252000},"page":"243-249","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["What makes a good head positioner for preventing occipital pressure ulcers"],"prefix":"10.1111","volume":"15","author":[{"given":"Rona","family":"Katzengold","sequence":"first","affiliation":[{"name":"Department of Biomedical Engineering, Faculty of Engineering Tel Aviv University  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0223-7218","authenticated-orcid":false,"given":"Amit","family":"Gefen","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, Faculty of Engineering Tel Aviv University  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,11,27]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"European Pressure Ulcer Advisory Panel(EPUAP) National Pressure Ulcer Advisory Panel (NPUAP) and the Pan\u2010Pacific Alliance (PPA) International Guidelines \u2018Aetiology\u2019 chapter;2014."},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1742-481X.2007.00330.x"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiomech.2013.04.001"},{"issue":"2","key":"e_1_2_6_5_1","first-page":"149","article-title":"Pressure sores\u2010a constant problem for plegic patients and a permanent challenge for plastic surgery","volume":"3","author":"Giuglea C","year":"2010","journal-title":"J Med Life"},{"key":"e_1_2_6_6_1","volume-title":"Patient Safety and Quality: An Evidence\u2010Based Handbook for Nurses","author":"Lyder CH","year":"2008"},{"key":"e_1_2_6_7_1","first-page":"CD009958","article-title":"Thalib L","volume":"4","author":"Gillespie BM","year":"2014","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.aorn.2014.06.004"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.aorn.2010.08.027"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/NCQ.0b013e3182a79ca9"},{"key":"e_1_2_6_11_1","unstructured":"Visible Human Project Gallery U.S. National Library of Medicine."},{"key":"e_1_2_6_12_1","unstructured":"Simpleware\u00ae Ltd. 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