643 The Latest Rendition of the Ring Neck Collar Formally Known as “Watusi”

Abstract

Abstract Introduction The “Watusi” neck collar originally described by Koenig has gone through a few renditions since it was introduced in 1976. Our facility adopted its use as described by Nosanov et. al, but have since made modifications to the construction that have improved positioning of the neck, patient comfort, and tolerance. Methods We used the construction design of the “Watusi” collar as described by Nosanov et. al. in 2017 • Measure patients neck length and circumference • Cut 3/8” plastic tubing • Cut a strip of 2”loop Velcro and sew a piece of hook Velcro to the underside of the loop Velcro for adhesive closure • Cut horizontal strips along the remaining loop Velcro and thread plastic tubing through Here we divert from the previously published design: • Cut ~ 8” piece of betapile and thread Velcro through (this is to pad the back of the neck). • Using 1 1/8” and 7/8” cylindrical foam tubes, cut a slit along the length of cylindrical foam to allow for insertion of the plastic tubes. This allows for ease of application and removal for hygiene/cleaning. • Lay the betapile pad on the posterior neck and apply the rings w/ cylindrical foam inserts (using clinical judgement regarding number and location of foam inserts until optimal neck position is achieved). Results We have used this method on 15 patients since 2017 and have found improved neck extension with use of foam inserts as well as pressure along cervicomental region (see attached photos). It continues to allow for some neck movement while applying targeted pressure over anterior/lateral neck bands. The removable foam inserts make cleaning easier compared to earlier versions. The application process of our modified ring neck collar is not as straight forward as alternative neck positioning devices and staff require additional training on proper application and management, however we find that when applied with adequate tension, the ring neck collar provides excellent targeted pressure to the cervicomental region as well as lateral neck bands to reduce banding and soft tissue contractures. Many patients report improved comfort with use of ring neck collar when compared to hard orthoplast anterior neck conformers and the associated risk of pressure injury is less than that of a hard neck conformer. Conclusions The modified ring neck collar can provide targeted pressure to soft tissue bands of the neck and should be considered as a tool to use to reduce risk of soft tissue neck contractures. Our facility will continue to utilize this device as well as seek ways to improve the design and patient tolerance.