A Randomized Clinical Trial on Preventing Pressure Ulcers with Wheelchair Seat Cushions
Article first published online: 10 NOV 2010
© 2010, Copyright the Authors. Journal compilation © 2010, The American Geriatrics Society
Journal of the American Geriatrics Society
Volume 58, Issue 12, pages 2308–2314, December 2010
How to Cite
Brienza, D., Kelsey, S., Karg, P., Allegretti, A., Olson, M., Schmeler, M., Zanca, J., Geyer, M. J., Kusturiss, M. and Holm, M. (2010), A Randomized Clinical Trial on Preventing Pressure Ulcers with Wheelchair Seat Cushions. Journal of the American Geriatrics Society, 58: 2308–2314. doi: 10.1111/j.1532-5415.2010.03168.x
- Issue published online: 9 DEC 2010
- Article first published online: 10 NOV 2010
- pressure ulcer;
- nursing home;
- seat cushion;
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 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 aged 65 and older who were using wheelchairs for 6 or more hours per day and had a Braden score of 18 or less and a combined Braden activity and mobility score of 5 or less. Participants were recruited from a referred sample.
INTERVENTION: All participants were provided with a fitted wheelchair and randomized into skin protection (SPC, n=113) or segmented foam (SFC, n=119) cushion groups. The SPC group received an air, viscous fluid and foam, or gel and 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 ulcers and ulcers over the sacrum and coccyx (sacral ulcers).
RESULTS: One hundred eighty participants reached a study end point, and 42 were lost to follow-up. Ten did not receive the intervention. There were eight (6.7%) IT ulcers in the SFC group and one (0.9%) in the SPC group (P=.04). There were 21 (17.6%) combined IT and sacral ulcers in the SFC group and 12 (10.6%) in the SPC group (P=.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.