
Peter WorsleyUniversity of Southampton · Faculty of Health Sciences
Peter Worsley
BSc, PhD
About
198
Publications
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Introduction
My research incorporates a multidisciplinary approach including academics from UoS, the UK, and overseas. His skills include physiological and biomechanical monitoring, imaging of musculoskeletal tissues and computational techniques to predict robust parameters which characterise medical device-body interactions. His research has been supported by UKRCs, NIHR, NHS Trusts (PhD studentships) and industry.
Additional affiliations
Publications
Publications (198)
Measuring interface pressure is currently used in a variety of settings, e.g., automotive or clinical, to evaluate pressure distribution at support surface interfaces. Commercial pressure sensing arrays are employed to monitor and visualise these pressure distributions to aid mattress or cushion selection by assessing their ability to redistribute...
Following lower limb amputation residuum skin from the lower leg is used to reconstruct the residual limb. Unlike skin on the sole of the foot (plantar skin), leg skin is not inherently load bearing. Despite this, leg skin is required to be load bearing in the prosthetic socket. Current hypotheses propose that lower limb amputee skin can adapt to b...
Introduction
Incontinence is commonly experienced by adults who receive care support in a residential facility or in their own home. These individuals are at risk of developing incontinence‐associated dermatitis (IAD), which is caused by prolonged and repeated exposure of the skin to urine or faeces. An IAD manual was developed providing an evidenc...
Poor socket fit is the leading cause of prosthetic limb discomfort. However, currently clinicians have limited objective data to support and improve socket design. Prosthesis fit could be predicted by finite element analysis to help improve the fit, but this requires internal and external anatomy models. While external 3D surface scans are often co...
Female development includes significant size changes across the breast. Yet, whether differences in breast surface area (BrSA) modify breast sensitivity to warm, cold and wetness, and the associated epidermal properties (skin thickness and surface roughness) remain unclear. We investigated the relationship between BrSA and thermal and wetness perce...
Prosthetic limbs deliver major quality of life and socioeconomic benefits for people with amputation, particularly in low-resource settings. The value of administrative data analysis to enable sustainable health care improvement is established, but there has been limited research into the failure, repair, and replacement of prosthetic limbs. Surviv...
Objective: Personalised prosthetic socket design depends upon skilled prosthetists who aim to balance functional human-prosthesis coupling with safe, comfortable load transmission to skin and soft tissues. This study's objective was to assess the comfort of sockets generated from past computer aided socket design records.
Design: A crossover non-in...
Female development includes significant morphological changes across the breast. Yet, whether differences in breast surface area (BrSA) modify breast skin stiffness and tactile sensitivity at rest and after exercise in the heat remain unclear. We investigated the relationship between BrSA and skin stiffness and tactile sensitivity in 20 young to mi...
Medical devices, such as non-invasive ventilation masks, save lives in health care settings but can be a cause of tissue injuries due to the pressure and shear loads on skin and soft tissue. These pressure injuries could be painful for the individual and cause a significant economic impact on healthcare providers. In the etiology of device related...
Introduction
Clinicians involved in lower-limb prosthetic provision and care do not have an objective method for measuring patients’ real-world prosthesis usage. This results in a poor understanding of the full picture of the patient’s everyday life impacting the reporting of outcome following prosthetic prescriptions. There is need to understand w...
Background:
Transtibial prosthetic sockets are often grouped into patella tendon bearing (PTB) or total surface bearing (TSB) designs, but many variations in rectifications are used to apply these principles to an individual's personalised socket. Prosthetists currently have little objective evidence to assist them as they make design choices.
Ai...
Background
Consumer products such as electrical shavers exert a combination of dynamic loading in the form of pressure and shear on the skin. This mechanical stimulus can lead to discomfort and skin tissue responses characterised as “Skin Sensitivity”. To minimise discomfort following shaving, there is a need to establish specific stimulus‐response...
Female development includes significant morphological changes across the breast. Yet, whether differences in breast surface area (BrSA) modify sweat gland density and output remains unclear. The present study investigated the relationship between BrSA and sweat gland density and output in 22 young to middle‐aged women (28±$\ \pm \ $10 years) of var...
July 2023 has been confirmed as Earth's hottest month on record, and it was characterized by extraordinary heatwaves across southern Europe. Field data collected under real heatwave periods could add important evidence to understand human adaptability to extreme heat. However, field studies on human physiological responses to heatwave periods remai...
Introduction Pressure ulcers (PUs) can develop from sustained periods of pressure and repeated shear forces causing localised damage to the skin and sub-dermal tissues (1). The annual cost of treating chronic wounds, including PUs, in the United Kingdom alone has been estimated at £8.3 billion (2). Evaluating the mechanisms underlying physiological...
Introduction
Pressure ulcers (PUs) constitute a localised damage to the skin resulting from prolonged periods of pressure and shear forces (1). In the United Kingdom alone, the annual cost of treating chronic wounds, including PUs, has been estimated to be approximately £8.3 billion (2). Accordingly, an improved understanding of the fundamental mec...
Introduction and aims
Lower limb prosthesis has proven to be an extremely successful intervention for amputees. However, to achieve adequate function, the device places significant friction and load on the skin, which leads to substantial skin breakdown. Current rehabilitation practices require skin to be ‘trained’ to perform a load-bearing role. D...
This study protocol aims to investigate how localised cooling influences the skin’s microvascular, inflammatory, structural, and perceptual tolerance to sustained mechanical loading at the sacrum, evaluating factors such as morphology, physiology, and perceptual responses. The protocol will be tested on individuals of different age, sex, skin tone...
Carbon dioxide (CO 2 ) emitted by the skin during loading is a potential biomarker for the early detection of pressure ulcers (PUs). In this work, a reflection mode optical fibre CO 2 sensor (OFCS) was developed for early prediction of PUs formation. The optical fibre tip was coated with thymol blue using a sol‒gel coating process. The highest abso...
Women continue to be under‐represented in thermoregulatory research despite their undergoing unique physiological changes across the lifespan. This study investigated the biophysical, thermo‐physiological, and perceptual determinants of cool‐seeking behaviour during exercise in younger and older women. Eleven younger (25 ± 5 years; 1.7 ± 0.1 m; 63....
PURPOSE
The purpose of this study was to evaluate temporal changes in skin responses following exposure to moisture alone or moisture in combination with mechanical loading.
DESIGN
Comparison cohort with a repeated-measures design.
SUBJECTS AND SETTINGS
The sample comprised 12 healthy volunteers. Participants were purposely sampled from 2 differe...
Commercial pressure monitoring systems have been developed to assess conditions at the interface between mattress/cushions of individuals at risk of developing pressure ulcers. Recently, they have been used as a surrogate for prolonged posture and mobility monitoring. However, these systems typically consist of high-resolution sensing arrays, sampl...
Preliminary human studies show that reduced skin temperature minimises the risk of mechanically induced skin damage. However, the mechanisms by which cooling enhances skin tolerance to pressure and shear remain poorly understood. We hypothesized that skin cooling below thermo-neutral conditions will decrease kinetic friction at the skin-material in...
Objectives
Respiratory protective equipment is critical to protect healthcare workers from COVID-19 infection, which includes filtering facepiece respirators (FFP3). There are reports of fitting issues within healthcare workers, although the factors affecting fitting outcomes are largely unknown. This study aimed to evaluate factors affecting respi...
In acute care facilities, the detection of pressure ulcers (PUs) relies on visual and manual examination of the patient's skin, which has been reported to be inconsistent and may lead to misdiagnosis. In skin and wound research, various biophysical parameters have been extensively employed to monitor changes in skin health. Nonetheless, the transit...
Aims:
To explore patient perceptions and understanding of their pressure ulcer risk and how information is communicated between a nurse and patient in the home setting.
Design:
A pragmatic qualitative research design including community-dwelling patients, who were deemed at risk of developing a pressure ulcer.
Methods:
Observation of routine i...
Pressure Ulcers (PU) are a major burden for affected patients and healthcare providers. Current detection methods involve visual assessments of the skin by healthcare professionals. This has been shown to be subjective and unreliable, with challenges associated with identifying erythema in darker colour skin. Although there exists a number of promi...
Purpose:
While innovation is known to catalyse solutions to global sustainable development challenges, lack of engagement from stakeholders during conceptualisation and development may influence the degree of success of implementation.
Methods and materials:
This paper presents a complete and novel engagement methodology, developed from value le...
Background
Skin is the largest organ in the body, representing an important interface to monitor health and disease. However, there is significant variation in skin properties for different ages, genders and body regions due to the differences in the structure and morphology of the skin tissues. This study aimed to evaluate the use of non‐invasive...
Differences in skin thermal sensitivity have been extensively mapped across areas of the human body, including the torso, limbs, and extremities. Yet, there are parts of the female body, such as the breast and the pelvis for which we have limited thermal sensitivity data. The aim of this study was to map cutaneous warm and cold sensitivity across s...
Introduction:
During the COVID-19 pandemic healthcare workers (HCWs) have used respiratory protective equipment for prolonged periods, which has been associated with detrimental effects on the underlying skin. The present study aims to evaluate changes in the main cells (corneocytes) of the stratum corneum (SC) following prolonged and consecutive...
Introduction:
Proteins, such as cytokines and chemokines, are present in varying concentrations in a range of biofluids, with an important signalling role in maintaining homeostasis. Commercial tapes have been employed to non-invasively collect these potential biomarkers in sebum from the skin surface to examine their concentrations in conditions...
The International Wound Dressing Technology Expert Panel has provided important work about the history of wound treatment dressing construction, development and testing methods related to clinical performance. As it now stands, these types of dressings require additional rigorous engineering testing to ensure that the indication of a dressing, whet...
Background
Personal protective equipment, including respirator devices, has been used to protect healthcare workers (HCWs) during the COVID‐19 pandemic. These are fitted to skin sites on the face to prevent airborne transmission but have resulted in reports of discomfort and adverse skin reactions from their continued usage. The present study addre...
N95/FFP3 respirators have been critical to protect healthcare workers and their patients from the transmission of COVID-19. However, these respirators are characterised by a limited range of size and geometry, which are often associated with fitting issues in particular sub-groups of gender and ethnicities. This study describes a novel methodology...
Background:
Prosthetic service development and delivery rely on data describing population needs. These needs are context-specific, but most existing data come from high-income countries or small geographic areas, which are often not comparable. This study analysed routinely collected digital patient record data at multiple time points to provide...
Preliminary human studies show that reduced skin temperature minimises the risk of mechanically-induced skin damage. However, the mechanisms by which cooling enhances skin tolerance to pressure and shear remain poorly understood. We hypothesized that skin cooling below thermo-neutral conditions will decrease friction at the skin-material interface....
Study design
Cohort observational study.
Objectives
To examine the movement profiles of individuals with spinal cord injury (SCI) during their inpatient rehabilitative phase using continuous pressure monitoring (CPM), evaluating the trends in those with skin damage.
Setting
SCI specialist rehabilitation centre in the United Kingdom.
Methods
Indi...
The present study sought to explore the impact of movement monitoring devices on risk prediction and prevention of pressure ulcers (PU) among adults. Using systematic review methodology, we included original research studies using a prospective design, written in English, assessing adult patients' movement in bed, using a movement monitoring device...
Background
Pressure ulcers are a complex healthcare issue. Hospital-acquired pressure ulcers are used as proxy measurements for the quality and safety of nursing care. Medical device-related pressure ulcers are mostly facility acquired, but their reporting has only recently been widely adopted. Consequently, we do not yet know what factors impact t...
Background
After amputation, many people become less active, feel lonely and lose independence. Understanding the factors associated with low physical activity levels and participation could contribute to defining key interventions which can support prosthesis users so they can live a more active and socially included lifestyle. This longitudinal o...
p>Although great strides have been made to tackle hospital-acquired pressure ulcers (HAPUs), there is a need for greater recognition of device-related pressure ulcers (DRPUs), including their causes, management and prevention. This consensus statement, an updated second edition, aims to continue raising awareness of these largely preventable injuri...
Purpose
Respiratory protective equipment is widely used in healthcare settings to protect clinicians whilst treating patients with COVID-19. However, their generic designs do not accommodate the variability in face shape across genders and ethnicities. Accordingly, they are regularly overtightened to compensate for a poor fit. The present study aim...
Foot orthoses are prescribed to reduce forefoot plantar pressures and pain in people with rheumatoid arthritis. Computational modelling can assess how the orthoses affect internal tissue stresses, but previous studies have focused on a single healthy individual. This study aimed to ascertain whether simplified forefoot models would produce differin...
Background: After amputation, many people become less active, feel lonely and lose independence. Understanding the factors associated with low physical activity levels and participation could contribute to defining key interventions which can support prosthesis-users so they can live a more active and socially inclusive lifestyle. This longitudinal...
Pressure ulcers (PUs) occur in a range of care settings, resulting in reduced quality of life for the individual. There has been a growing awareness that medical devices can cause PUs, although reporting has been limited. There is a need to evaluate PU reporting practice and identify whether standards exist for medical device-related pressure ulcer...
Introduction
Black, Asian and minority ethnic (BAME) people are disproportionately affected by COVID-19. Respiratory protective equipment (RPE) has conventionally been developed for a predominantly white male population that does not represent the healthcare workforce. The literature was reviewed to determine the protection offered to female and BA...
Liquid chromatography‐mass spectrometry methods were required to afford the rapid separation and detection of purines and small organic acids. These compounds are found in sweat and sebum and are potential biomarkers for the early detection of pressures sores. Two ultrahigh‐performance supercritical fluid chromatography‐mass spectrometry assays hav...
Digital technologies can provide information to support the conventional methods used to develop prosthetics. However,there is little research into which technologies are useful for prosthetists and prosthesis-users, particularly in low resourced countries.
Background
Skin sensitivity (SS) is a commonly occurring response to a range of stimuli, including environmental conditions (e.g., sun exposure), chemical irritants (e.g., soaps and cosmetics), and mechanical forces (e.g., while shaving). From both industry and academia, many efforts have been taken to quantify the characteristics of SS in a standa...
Despite the potential for biomechanical conditioning with prosthetic use, the soft tissues of residual limbs following lower-limb amputation are vulnerable to damage. Imaging studies revealing morphological changes in these soft tissues have not distinguished between superficial and intramuscular adipose distribution, despite the recognition that i...
A novel engagement methodology is presented for working with multi-sector stakeholders. The proposed methodology can be used to determine barriers and facilitators to translational research within a country-specific context by working with stakeholders in a responsive and collaborative way. A values-based stakeholder ethos throughout a research pro...
Background:
Skin is constantly exposed to mechanical and chemical insults, in the form of prolonged loading, overhydration or exposure to irritants. An array of non-invasive biophysical tools has been adopted to monitor the changes in skin response. The present study aims to identify a set of robust parameters sensitive to mechanical and chemical...
Temperature and humidity conditions at the interface between a support surface and the skin, termed microclimate, has been implicated in the development of pressure ulcers. Support surface technologies have been developed to control microclimate conditions, although only a few standard test methods exist to evaluate their performance. This study de...
Despite the potential for biomechanical conditioning with prosthetic use, the soft tissues of residual limbs following lower-limb amputation are vulnerable to damage. Imaging studies revealing morphological changes in these soft tissues have not distinguished between superficial and intramuscular adipose distribution, despite the recognition that i...
Synthetic clays are promising biomaterials for delivery of therapeutic molecules in regenerative medicine. However, before their use can be translated into clinical applications, their safety must be assessed in human volunteers. The aim of this study was to test the hypothesis that a synthetic nanoclay (LAPONITE) does not cause irritation to the h...