Pressure ulcer prophylaxis in elderly patients using polyurethane foam or Jay® wheelchair cushions

Conine, Tali A.; Hershler, C.; Daechsel, Dawn; Peel, Carol; Pearson, A. Jane

doi:10.1097/00004356-199406000-00003

Cited by 64 publications

(42 citation statements)

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“…They found that higher interface pressure measurements were associated with a higher incidence of sitting-acquired PUs. Similarly, Conine et al studied the effectiveness of Jay cushions in PU prevention in 163 elderly persons who used wheelchairs [38]. They found that the incidence of PUs was significantly higher among those persons with high peak pressures of 60 mmHg or higher.…”

Section: Discussionmentioning

confidence: 99%

Pressure changes under the ischial tuberosities of seated individuals during sacral nerve root stimulation

Liu

Nicholson²,

Knight³

et al. 2006

JRRD

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Abstract-Neuromuscular stimulation via the sacral nerve roots is proposed for prevention of ischial pressure ulcers following a spinal cord injury (SCI). Acute effects of sacral functional magnetic stimulation (FMS) on seat interface pressure changes were investigated in five nondisabled volunteers. Similar effects were demonstrated with functional electrical stimulation in people with SCI who used a sacral anterior root stimulator implant. The results indicated that sacral nerve root stimulation, either by FMS or implanted electrical stimulation, induced gluteus maximus contraction and mild pelvic tilt sufficient for clinically significant reductions in ischial pressures during sitting.

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Section: Discussionmentioning

confidence: 99%

Pressure changes under the ischial tuberosities of seated individuals during sacral nerve root stimulation

Liu

Nicholson²,

Knight³

et al. 2006

JRRD

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“…Indirect measures, specifically interface pressures, comprise the bulk of studies on cushions [13][14][15][16]. Researchers have shown tha t high seated interface pressures were associated with PU occurrence [17][18][19]. Therefore, despite the limita tions in IPM as a less accurate representation of localized loading [5,[20][21][22], it can be useful in selecting cushions.…”

Section: Support Surfacesmentioning

confidence: 99%

Assessing evidence supporting redistribution of pressure for pressure ulcer prevention: A review

Sprigle¹,

Sonenblum²

2011

JRRD

102

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Abstract-The formation and underlying causes of p ressure ulcers (PUs) are quite complex, with multiple influencing factors. However, by definition pressure ulcers cannot form without loading, or pressure, on tissue. Clinical interventions typically target the magnitude and/or duration of loading. Pressure magnitude is managed by the selection of support surfaces and postural supports as well as body posture on supporting surfaces. Duration is addressed via turning and weight shifting frequency as well as with th e use of dynamic s urfaces that actively redistribute pressure on the body surfaces. This article shows that preventative interventions must be targeted to both magnitude and duration and addresses the rationale behind several common clinical interventions-some with more scientific evidence than others.

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“…Individuals who cannot independently reposition tend to be at the greatest risk for ulcer development 10. Several studies have indicated that the use of pressure-redistributing wheelchair cushions designed to maintain tissue integrity will reduce the incidence of sitting-induced pressure ulcers 5, 11, 7, 12, 13, 14…”

Section: Introductionmentioning

confidence: 99%

A Randomized Clinical Trial on Preventing Pressure Ulcers with Wheelchair Seat Cushions

Brienza

Kelsey²,

Karg³

et al. 2010

J American Geriatrics Society

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Objectives To determine the efficacy of skin protection wheelchair seat cushions in preventing pressure ulcers in the elderly, nursing home population Design Clinical trial with participants assigned at random to either a skin protection or segmented foam cushion. Two hundred thirty two participants were recruited between June 2004 and May 2008 and followed for 6 months or until pressure ulcer incidence. Setting Twelve nursing homes Participants Nursing home residents’ age ≥ 65, using wheelchairs ≥6 hours/day, Braden score ≤ 18, and combined Braden activity and mobility score ≤ 5. Participants were recruited from a referred sample. Intervention All participants were provided a fitted wheelchair and randomized into skin protection (SPC) or segmented foam (SFC) cushion groups. The SPC group received an air, viscous fluid/foam, or gel/foam cushion. The SFC group received a 7.6 cm crosscut foam cushion. Measurements Pressure ulcer incidence over 6 months for wounds near the ischial tuberosities (IT ulcers) were measured. Secondary analysis was performed on combined IT and sacral/coccyx ulcers. Results One hundred eighty participants reached a study endpoint and 42 were lost to follow-up. Ten did not receive the intervention. There were 8/119 (6.7%) IT ulcers in the SFC group and 1/113 (0.9%) in the SPC group (p<0.04). In the group of combined IT and sacral/coccyx ulcers, there were 21/119 pressure ulcers (17.6%) in the SFC group and 12/113 (10.6%) in the SPC group (p=0.14). Conclusion Skin protection cushions used with fitted wheelchairs lower pressure ulcer incidence for elderly, nursing home residents and should be used to help prevent pressure ulcers.

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Pressure ulcer prophylaxis in elderly patients using polyurethane foam or Jay® wheelchair cushions

Cited by 64 publications

References 0 publications

Pressure changes under the ischial tuberosities of seated individuals during sacral nerve root stimulation

Pressure changes under the ischial tuberosities of seated individuals during sacral nerve root stimulation

Assessing evidence supporting redistribution of pressure for pressure ulcer prevention: A review

A Randomized Clinical Trial on Preventing Pressure Ulcers with Wheelchair Seat Cushions

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