Initial Clinical Observations of the Role of a New Alternating Pressure Cushion in the Healing of Established Pressure Sores

Abstract

mattresses and cushions then used to assist the healing of established sores. Few varieties of pressure-redistributing surfaces for use in bed were encountered, with the most common support surface being the large cell ripple mattress (49% of all mattress and bed use). Whereas patients with established sores were seated on 30 different special cushions, many (n=24) of which were rarely encountered, being used with fewer than 9 patients. Clark and Crow 2 also noted the wide range of cushions available for use in hospital, again many were rare, with often only one of any particular type of cushion available. Why are such a variety of special cushions used? - particularly when one considers that special mattress and bed use has become more focused upon a narrow range of products 3 • One potential reason for the diversity of cushions used within the NHS is the current lack of clear evidence that these products are effective. Even when indirect evidence of effectiveness, such as interface pressure measurements are considered, the available data does not greatly assist care providers to make considered judgments of the relative merits of different products. Souther et al 4 having measured interface pressures beneath the right ischial tuberosity of subjects sitting upon a variety of cushions concluded that 'No cushion evaluated reduced mean pressure below mean capillary pressure' and that 'this goal may not be attainable'. Hibbs 5 made recommendations for the widespread use of an air-filled cushion, the ROHO (Raymar, Hodgkinson & Corby Ltd). Even this product applies relatively high pressures to the ischial tuberosities; for example among tetraplegic subjects, an average interface pressure beneath the ischial tuberosities of71.5 mmHg has been recorded 6 • Given the uncertain effectiveness of cushions that are currently available, Bliss 7