People who have severely limited mobility and spend a lot of time in a wheelchair are at risk of developing pressure ulcers. In this interesting article, specialists address the importance of correct choice of cushion to prevent this pathology.
Not all people and not all buttocks or buttocks are the same. It is true that, like tastes, everyone has their own. For this reason, when a patient sits in a wheelchair on a cushion, the pressure on the user-pad interface It will depend on several factors, some have to do with the characteristics of the user and others with those of the cushion. In addition, a correct adaptation between the user and the seating equipment can also have an influence.
There is different variables to consider from the user’s point of view, such as weight, size and shape of the thighs and buttocks, the level of the lesion, the presence of scoliosis and/or pelvic asymmetry, the distribution and thickness of the soft tissues that surround and protect the bony prominences and that the greater the atrophy of the soft parts, the more prominent are the bony areas, the positioning and the balance during sitting.
In the same way, in relation to the cushion you have to consider the size, shape, construction material, as well as the inflation pressure in air cushions.
Conscious of this fact, he has a seated pressure distribution analysis system, which has already carried out more than 780 reports, a considerable number that will be used in the future to carry out a study of great scientific and statistical value. All this accumulated information serves in any case to argue the following ideas:
· Choosing the most suitable cushion for each user is crucial when it comes to preventing pressure ulcers.
· There is no single anti-decubitus cushion that works for all users.
It is important that patients sit on suitable cushions to prevent the development of bedsores. A poorly fitted, maintained or prescribed cushion helps to develop a pressure ulcer.
The different inflation pressure of an air cushion influences not only the pressure distribution at the user-cushion interface, but also the degree of pressure on bony prominences. This optimal inflation pressure must be established initially with objective measurement systems and not empirically.
The smaller the Contact arealess ability to redistribute pressure, and correct inflation pressure increases the contact surface and decreases pressure on bony prominences.
He asymmetrical weight or irregular on the pelvis, increases the exposure of the bony prominences to pressure, so correct positioning is essential.
The maintenance of a constant pressure It favors the development of a bedsore, therefore, in addition to using an anti-decubitus cushion, pressure relief techniques and weight modification are essential.
Avoid cushions in the shape of a horseshoe or donuts Since they do not distribute the pressure exerted by the body weight, they produce a compressive effect, edema, congestion and ischemia, favoring the development of bedsores.
There are different equipment available in the market. Each one of them has certain characteristics that provide it with differentiated behavior and specific indications depending on the surface to be measured, to the point of finding differences in pressure values in the same patient with the same cushion depending on the measurement device used.
Ultimately, it is recommended carrying out an analysis of the distribution of pressures in sitting position since it will not only help us to objectively identify and quantify the pressure that exists in the areas at risk of suffering from bedsores, but it will help us to objectively choose the most suitable cushion for each patient.
For all these reasons, it would be advisable for air cushions to determine the inflation pressure that provides the best results in the pressure distribution and, once these values have been established, the user can have a “fit” manometer (somewhat difficult) to check at home that, at all times, it adjusts to the recommended values, for this reason it is essential to use palpation manual and observation, to check the optimal level at the patient-pad interface.
We must achieve the best possible sitting position in such a way that it provides a adequate protection against pressure and finally, remember that weight shifts and pressure relief techniques are necessary to prevent the development of an eschar.
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