A Randomized Clinical Trial on Preventing Pressure Ulcers With Wheelchair Seat Cushions
By Brienza, David; Kelsey, Sheryl; Karg, Patricia; Allegretti, Ana; Olson, Marian; Schmeler, Mark; Zanca, Jeanne; Geyer, Mary Jo; Kusturiss, Marybeth; Holm, Margo; Journal of the American Geriatrics Society, Volume 58, Number 12, pages 2308-2314Publication Date: December 2010
Study assessed the efficacy of skin protection wheelchair seat cushions in preventing pressure ulcers in elderly nursing home residents. Specifically, the trial tested the hypothesis that the incident of sitting-acquired pressure ulcers is greater for at-risk elderly wheelchair users seated on segmented foam seat cushions (SFCs) than for those using appropriate skin protection cushions (SPCs). SPCs are designed to maintain tissue integrity by reducing pressures near bony prominences, accommodating orthopedic deformities through immersion, and regulating dissipation of heat and moisture. Participants were 232 nursing home residents aged 65 or older who used wheelchairs more than 6 hours a day. Participants were provided a fitted wheelchair and randomized into SPC or SFC groups. The SPC group received an air, viscous fluid/foam, or gel/foam cushion, while the SFC group received a 7.6 centimeter crosscut foam cushion. All participants were followed for 6 months or until pressure ulcer incidence. IT ulcers, or wounds occurring near the ischial tuberosities, were measured, and secondary analysis was performed on combined IT and sacral/coccyx ulcers. A total of 180 participants reached a study endpoint, while 42 were lost to follow-up and 10 did not receive the intervention. There was a 6.7 percent occurrence of IT ulcers in the SFC group and a 0.9 percent occurrence in the SPC group. In the group of combined IT and sacral/coccyx ulcers, there was a 17.6 percent occurrence in the SFC group, and a 10.6 percent occurrence in the SPC group. Based on study results, the use of SPCs is recommended for lowering pressure ulcer incidence in elderly wheelchair users.
Published by: Blackwell Publishing, Incorporated (Website: http://www.blackwellpublishing.com)
Link to text: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3065866/
