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Randomised controlled trial
Skin protection wheelchair cushions for older nursing home residents reduce 6-month incidence of ischial tuberosity pressure ulcers compared with segmented foam cushions
  1. Dimitri Beeckman1,2,
  2. Katrien Vanderwee2
  1. 1King's College London, Florence Nightingale School of Nursing & Midwifery, Department of Adult Nursing, London, UK
  2. 2Ghent University, Department of Public Health, Nursing Science Unit, Belgium
  1. Correspondence to: Dimitri Beeckman
    James Maxwell Building, 57 Waterloo Road, London SE1 8WA, UK; dimitri.beeckman{at}kcl.ac.uk

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Implications for practice and research

  • A pressure redistributing wheelchair cushion, used in a fitted wheelchair, is recommended to reduce the incidence of sitting-acquired pressure ulcers in nursing home residents.

  • Selecting a wheelchair cushion must be a thought-out and well-advised decision and must be based on the expertise of a multidisciplinary team specialised in seating and mobility.

  • Wheelchair fit and function must be monitored and adjusted frequently to avoid missing foot and arm rests which may cause more pressure and shear on the bony prominences.

  • More research is needed to study the effect of repositioning protocols (posture and frequency) for at-risk patients seated in a wheelchair.

Context

When seated in a chair, the body weight causes the greatest exposure to pressure over the ischial tuberosities.1 As a result of the rather small loaded area, pressure will increase significantly. Without appropriate reduction of pressure and shear, a pressure ulcer may occur very quickly.

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