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Randomized Controlled Trial
. 2010 Dec;58(12):2308-14.
doi: 10.1111/j.1532-5415.2010.03168.x. Epub 2010 Nov 10.

A randomized clinical trial on preventing pressure ulcers with wheelchair seat cushions

David Brienza  1 , Sheryl Kelsey, Patricia Karg, Ana Allegretti, Marian Olson, Mark Schmeler, Jeanne Zanca, Mary Jo Geyer, Marybeth Kusturiss, Margo Holm
Affiliations
Randomized Controlled Trial

A randomized clinical trial on preventing pressure ulcers with wheelchair seat cushions

David Brienza et al. J Am Geriatr Soc. 2010 Dec.

Abstract

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.

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Figures

Figure 1
Figure 1
Participant flowchart
See this image and copyright information in PMC

Comment in

References

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