The Relationship Between Pressure Ulcer Incidence and Buttock-Seat Cushion Interface Pressure in At-Risk Elderly Wheelchair Users

Abstract

Objective:To investigate the relation between pressure ulcer incidence and buttock-wheelchair seat cushion interface pressure measurements. Design:Secondary analysis of data from a randomized clinical trial. Setting:Skilled nursing facility. Patients:Thirty-two elderly patients (age, ⩾ 65yr), with Braden score ⩽ 18 and Braden mobility and activity subscale scorche ⩽ 5, who used wheelchairs ⩾ 6hr/d, were free of existing sitting-induced pressure ulcers, and weighed ⩽ 2501b. Interventions:Generic foam seat cushion or pressure-reducing seat cushion. Main Outcome Measures:The incidence of sitting-induced pressure ulcers over a 1- to 12-month period was compared with pressure measured between patients' buttocks and wheelchair seat cushions. A flexible pad with a 15 × 15 pressure sensor array was used to measure interface pressure. Results:Interface pressure measured on wheelchair seat cushions was higher (p ⩽ .01 for both peak pressure and average of highest 4 pressures) for patients who developed sitting-acquired pressure ulcers compared with those patients who did not. Conclusions:Results indicated that higher interface pressure measurements are associated with a higher incidence of sitting-acquired pressure ulcers for high-risk elderly people who use wheelchairs.